Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus

Kwon, Dae Gyu; Moon, Kyoung Ho; Na, Suk In; Shin, Byung Ki; Lee, Tong Joo

doi:10.12671/jkfs.2012.25.3.185

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Yet the clinical outcomes associated with our wide anterior approach to the entire length of the humerus have been shown to be comparable to those associated with the lateral and the posterior approaches for internal fixation. 9,[14][15][16] In sum, we propose that our wide anterior approach is effective for the treatment of comminuted and segmental fractures along the entire length of the humerus, of distal shaft fractures, and of humeral lesions.…”

Section: Discussionmentioning

confidence: 91%

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Lee¹,

Choi²,

Kim³

et al. 2016

Clinics in Shoulder and Elbow

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Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for frac tures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single inci sion. Postoperatively, we mea sured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an aver age 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final followup (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of seg mental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation. (Clin Shoulder Elbow 2016;19(4):223-228)

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Section: Discussionmentioning

confidence: 91%

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Lee¹,

Choi²,

Kim³

et al. 2016

Clinics in Shoulder and Elbow

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Posterior Dual Plating for Distal Shaft Fractures of the Humerus

2017

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Purpose:To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus. Materials and Methods:We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs.Results: Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery. Conclusion:Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.

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Modified Combined Approach for Distal Humerus Shaft Fracture: Anterolateral and Lateral Bimodal Approach

Lee

Kwon

et al. 2013

Clin Orthop Surg

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BackgroundDue to the anatomical nature of the radial nerve, dissection and attainment of an adequate operative field in mid to distal humerus fracture is dangerous and limited. We devised a combined anterolateral and lateral approach that ensures protection of the radial nerve. This is achieved by performing bimodal dissection of the proximal humerus anteriorly and the distal humerus laterally.MethodsThirty-five consecutive patients were treated using a combined anterolateral and lateral approach for a minimum follow-up period of 24 months. We analyzed time to bony union, time to return to daily work, range of motion, elbow joint function as assessed by the Mayo elbow performance index and complications.ResultsRadiologic bony union was observed at 11.2 weeks (range, 8 to 20 weeks) on average. Four cases of incomplete radial nerve palsy before surgery all recovered. Time to return to work was 10.2 weeks (range, 2 to 32 weeks) on average. The average range of motion of the elbow was 3.3° (range, 0° to 10°) of extension and 135.9° (range, 125° to 145°) of flexion. There were 21 cases of excellent and 13 cases of good or better recovery, comprising over 97.1% on the Mayo elbow performance index. There were no complications of radial nerve palsy, non-union, mal-union, or infection.ConclusionsOur a modified combined anterolateral and lateral approach is a clinically effective surgical method of achieving protection of the radial nerve and securing easy and firm internal fixation.

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Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus

Cited by 3 publications

References 6 publications

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

Posterior Dual Plating for Distal Shaft Fractures of the Humerus

Modified Combined Approach for Distal Humerus Shaft Fracture: Anterolateral and Lateral Bimodal Approach

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