Das präformierte LCP®-Plattenfixateursystem bei distalen Humerusfrakturen AO-Typ 13C3

Abstract

In distal intraarticular humerus fractures primary stable osteosynthesis is essential for early mobilization of the elbow joint. Double-plate osteosynthesis techniques using different configurations are the gold standard. In the literature plate position is sometimes discussed controversially. In cases of distal humerus fractures (type AO 13C3) with metaphyseal comminution, as well as in elderly patients with poor bone quality, utilizing locking plates with angular stability was found to have increased structural properties with regard to primary fixation stability. The dorsal approach with osteotomy of the olecranon seems to be very effective in open reduction and internal fixation of this type of fracture. One new development is the anatomically preformed plate-fixation systems such as the LCP-System for distal humerus (Synthes). This study presents our first experience with this system in 11 cases of open reduction and internal fixation of type AO 13C3 distal humerus fractures. The system-specific features and intraoperative options were analyzed.

Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

“…Furthermore, in this study, most patients had relatively low-energy traumata compared with other clinical trials. 9,29,33 This may limit comparability of our data with these studies. 9,29,33 In addition, only one type of plating was tested, so no direct comparison may be made with other plating systems or techniques such as parallel plating.…”

“…Actually, in our study, the time from injury to definite surgical treatment was shorter than what has been reported in the study of Reising et al 29 A postoperative ulnar neuropathy developed in 2 of the 22 patients (9%) in this study. Even though this rate is relatively low compared with 6% to 27% reported in other clinical trials, 1,8,15,21,29,32,33 postoperative ulnar neuropathy remains a major problem of internal fixation of fractures of the distal humerus. Transposition of the ulnar nerve in elbow trauma is controversial because some authors recommend routine transposition whereas others do not.…”

“…Recently, several studies have evaluated short-term results after the use of the DHP system. 8,29,33 Greiner et al 8 treated 14 patients with a mean age of 55 years and type B and C fractures of the distal humerus with the DHP system, finding a mean DASH score of 18.5 points and a mean MEPS of 91 points after a mean follow-up of 10 months. Rübberdt et al 33 evaluated a younger collective of 11 patients (mean age, 44 years) with type C fractures of the distal humerus, finding a mean DASH score of 51 points and a mean MEPS of 81 points.…”

“…Clinical results after non-locking parallel plating 1,26,34 are comparable to what has been reported for locked orthogonal plating with the DHP system. 8,29,33 Some authors suggested that stable distal fixation of the distal articular fragments according to the keystone model 34 may be a major factor influencing fixation stability. 26,34 Both the DHP system and the Mayo Elbow Congruent Plate System offer the option to insert several distal screws to fix keystone fragments, which may explain the comparable results.…”

“…In our department, this system has been consecutively used since 2004. Several studies have reported promising preliminary results after the use of this device, 8,29,33 but until recently, midterm results after open reduction and internal fixation (ORIF) with the DHP system have remained sparse. Therefore, the purpose of this study was to evaluate the clinical and radiologic outcome after a minimum follow-up of 2 years after open reduction and fixation of fractures of the distal humerus with the DHP system and compare these results with data in the literature.…”