Outcome analysis of intercondylar humerus fractures treated by locking compression plates

  • Dr. Vipendra Singh PG Resident, Department Of Orthopaedics, Gandhi Medical College, Bhopal. MP, India
  • Dr. Suresh Uikey Assistant Professor, Department. Of Orthopaedics, Gandhi Medical College, Bhopal. MP, India
  • Dr. Ajit Ganvir Assistant Professor, Department Of Orthopaedics, Gandhi Medical College, Bhopal. MP, India
  • Dr. (Prof.) Deepak S. Maravi Professor, Department Of Orthopaedics, Gandhi Medical College, Bhopal. MP, India
  • Prof. Dr. Sanjiv Gaur Professor, Department Of Orthopaedics, Gandhi Medical College, Bhopal. MP, India
DOI: https://doi.org/10.17511/ijmrr.2016.i03.23
Keywords: Elbow joint, Intra-articular fractures, Locking compression plates

Abstract

Background: Distal humeral fractures are uncommon fractures. They occur in both younger as well as older patients. The complex shape of the elbow joint, the adjacent neurovascular structures, the sparse soft tissue cover combine to make treatment difficult. Previous methods of conservative treatment have caused significant functional impairment. Thus the consensus has shifted towards treatment with open reduction and internal fixation so as to provide stability and early mobilization. Different modalities like 1/3rd tubular plate, reconstruction plate, K wires, double tension band wiring have been tried. The quality of elbow function following the treatment is related to the degree to which the normal anatomic relationships are restored.

Materials and Methods: 27 patients of Intercondylar Humerus fractures classified by Riseborough & Radin system and treated by ORIF by pre-contoured AO Locking compression plates. Clinical and radiological follow-up performed and patients assessed for pain, range of motion, and Mayo elbow performance score.

Results: Average follow up was of 6 months. Average age was 37.5 years (18-62 years). Fracture consolidation observed at an average of 12.8 weeks (10-14 weeks). The outcome was excellent or good in 17 patients. 3 patients had infection, 1 case each of ulnar neuropathy, mal-union and myositis ossificans. There were no cases of implant migration, secondary displacement or implant failure.

Conclusion: Anatomically pre-shaped distal humerus locking plate system is useful in providing stable fixation for complex distal articular fracture and facilitating early postoperative rehabilitation. The low rate of implant failure in the present study indicates that the technique is promising.

Downloads

Download data is not yet available.

References

1. Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma. 2003 Jan;17(1):38-47. Adult distal humeral metaphyseal fr.

2. Charnley J. The Closed Treatment of Common Fractures. 3rd ed. Baltimore: Williams & Wilkins; 1961.

3. Self J, Viegas SF, Buford WL Jr, Patterson RM. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg. 1995 Jan-Feb;4(1 Pt 1):10-6. [PubMed]

4. Riseborough EJ, Radin EL. Intercondylar T fractures of the humerus in the adult. A comparison of operative and non-operative treatment in twenty-nine cases. J Bone Joint Surg Am. 1969 Jan;51(1):130-41. [PubMed]

5. Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am. 1992 Apr;74(4):479-90. [PubMed]

6. Gupta R, Khanchandani P. Intercondylar fractures of the distal humerus in adults: a critical analysis of 55 cases. Injury. 2002 Jul;33(6):511-5. [PubMed]

7. Jupiter JB, Mehne DK. Fractures of the distal humerus. Orthopedics. 1992 Jul;15(7):825-33. [PubMed]

8. Wei W, Zhang T, Xin J. The treatment and its results of type C fractures of distal humerus. Chin J Orthop. 2005;25(11):679. [PubMed]

9. Yang KH, Park HW, Park SJ, Jung SH. Lateral J-plate fixation in comminuted intercondylar fracture of the humerus. Arch Orthop Trauma Surg. 2003 Jun;123(5):234-8. Epub 2003 Apr 25. [PubMed]

10. Zhao J, Wang X, Zhang Q. Surgical treatment of comminuted intra-articular fractures of the distal humerus with double tension band osteosynthesis. Orthopedics. 2000 May;23(5):449-52. [PubMed]

11. Athwal GS, Rispoli DM, Steinmann SP. The anconeus flap transolecranon approach to the distal humerus. J Orthop Trauma. 2006 Apr;20(4):282-5. [PubMed]

12. Jacobson SR, Glisson RR, Urbaniak JR. Comparison of distal humerus fracture fixation: a biomechanical study. J South Orthop Assoc. 1997 Winter;6(4):241-9. [PubMed]

13. Muzaffar N, Bhat K, Ahmad R, Wani R, Dar M. Functional results after osteosynthesis of distal humeral fractures with pre-contoured LCP system. Ortop Traumatol Rehabil. 2014 Jul-Aug;16(4):381-5. doi: 10.5604/15093492.1119615.

14. Atalar AC, Demirhan M, Salduz A, Kiliçoğlu O, Seyahi A. [Functional results of the parallel-plate technique for complex distal humerus fractures]. Acta Orthop Traumatol Turc. 2009 Jan-Feb;43(1):21-7. doi: 10.3944/AOTT.2009.021.

15. Pankaj A, Mallinath G, Malhotra R, Bhan S. Surgical management of intercondylar fractures of the humerus using triceps reflecting anconeus pedicle (TRAP) approach. Indian J Orthop. 2007 Jul;41(3):219-23. doi: 10.4103/0019-5413.33686.

16. Kumar MN, Ravishankar MR, Manur R Single locking compression plate fixation of extra-articular distal humeral fractures. J Orthopaed Traumatol (2015) 16:99–104.

17. Georgiades Ch, Matějka J, Pavelka T, Houček P. [Treatment of distal humeral fractures by open reduction and internal LCP-DHP fixation]. Acta Chir Orthop Traumatol Cech. 2010;77(6):479-83. [PubMed]

18. Ali AM, Hassanin EY, El-Ganainy AE, Abd-Elmola T. Management of intercondylar fractures of the humerus using the extensor mechanism-sparing paratricipitalposterior approach. Acta Orthop Belg. 2008 Dec;74(6):747-52. [PubMed]

19. Lakhey S, Sharma S, Pradhan RL, Pandey BK, Manandhar RR, Rijal KP. Osteosynthesis of intercondylar humerus fracture using Bryan and Morrey approach. Kathmandu Univ Med J (KUMJ). 2010 Apr-Jun;8(30):154-7. [PubMed]

20. Gupta RK, Gupta V, Marak DR. Locking plates in distal humerus fractures: study of 43 patients. Chin J Traumatol. 2013;16(4):207-11. [PubMed]

21. Gofton WT, Macdermid JC, Patterson SD, Faber KJ, King GJ. Functional outcome of AO type C distal humeral fractures. J Hand Surg Am. 2003 Mar;28(2):294-308. [PubMed]

22. Kundel K, Braun W, Wieberneit J, Rüter A. Intraarticular distal humerus fractures. Factors affecting functional outcome. Clin Orthop Relat Res. 1996 Nov;(332):200-8. [PubMed]

23. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res. 1993 Jul;(292):26-36. [PubMed]

24. Reising K, Hauschild O, Strohm PC, Suedkamp NP. Stabilisation of articular fractures of the distal humerus: early experience with a novel perpendicular platesystem. Injury. 2009 Jun;40(6):611-7. doi: 10.1016/j.injury.2008.12.018. Epub 2009 Apr 19. [PubMed]

25. Flinkkilä T, Toimela J, Sirniö K, Leppilahti J. Results of parallel plate fixation of comminuted intra-articular distal humeral fractures. J Shoulder Elbow Surg. 2014 May;23(5):701-7. doi: 10.1016/j.jse.2014.01.017.
Outcome analysis of intercondylar humerus fractures treated by locking compression plates
CITATION
DOI: 10.17511/ijmrr.2016.i03.23
Published: 2016-03-31
How to Cite
1.
Singh V, Uikey S, Ganvir A, S. Maravi D, Gaur S. Outcome analysis of intercondylar humerus fractures treated by locking compression plates. Int J Med Res Rev [Internet]. 2016Mar.31 [cited 2024Dec.22];4(3):414-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/492
Issue
Vol 4 No 3 (2016): MARCH
Section
Original Article