Distal humeral coronal plane fractures: management, complications and outcome

Durakbaşa, Mehmet Oğuz; Gümüşsuyu, Gürkan; Gungor, Mutlu; Ermiş, Mehmet Nurullah

doi:10.1016/j.jse.2012.07.011

Cited by 30 publications

(39 citation statements)

References 29 publications

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“…Generally speaking, the prognosis was worse as the degree of fracture comminution increased and type 3 fractures are associated with a poorer prognosis. This is consistent with previous reports that the greater the fragmentation of the articular surface, the worse the outcome 4,7 .…”

Section: Prognosis Of Different Type Fracturessupporting

confidence: 93%

“…But malreduction and poor fixation still can cause elbow dysfunction. Some complications such as nonunion, degenerative arthritis, heterotopic ossification, avascular necrosis, and stiff elbow had been reported previously 4,5,7,8 .…”

Section: Introductionmentioning

confidence: 96%

“…Because of the rotation and separation of the subchondral fragments of capitellum and trochlea, the standard lateral view of the elbow can depict a typical "double arc" sign in some cases 3 . Computer tomography (CT) and threedimensional reconstruction can completely show the location and quantity of the fractures, the range of involvement, displacement, concomitant injuries, which are helpful to make a correct preoperative plan [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Comminuted Coronal Shear Fracture of Distal Humerus

Teng

Zhong

2020

Orthopaedic Surgery

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Objective: To investigate the surgical approach, fixation, and clinical effect of comminuted coronal shear fracture of distal humerus. Methods: From March 2017 to February 2019, we had used open reduction and internal fixation to treat 19 cases of comminuted distal humeral coronal shear fracture. There were 8 males and 11 females, with an average age of 44.6 years (19-72 years). There were 10 cases on left side and 9 cases on right side. All cases were closed fractures. According to Dubberley's classification, there were six cases of type 1, six cases of type 2, and seven cases of type 3. The lateral Kocher approach, extended Kocher approach, extended Kocher approach combined with a medial incision and the olecranon osteotomy approach were used for exposure. Headless screw, Kirschner wire, and suture were used to fix the fractures. Two cases were fixed with hinged elbow fixators additionally. The follow-up was evaluated by Mayo Elbow Performance Score (MEPS). Results: All patients were followed up for an average of 17.1 months (range, 12 to 30 months). The average time of fracture union was 8.8 ± 1.9 weeks. There were three cases of degenerative osteoarthritis of elbow and one case of heterotopic ossification after operation. A total of 10 patients underwent removal of implants. At the last follow-up, the elbow flexion-extension arc was 130.5 ± 10.5. The forearm rotation arc was 167.4 ± 6.1. The MEPS was 85.8 ± 8.5, the results were classified as excellent in nine cases, good in eight, and fair in two. The excellent and good rate was 89.5%. The time of fracture union of type 1 was shorter than type 3 (P = 0.024), the elbow flexionextension arc of type 1 fracture was better than type 2 (P = 0.043) and type 3 (P = 0.012), the forearm rotation arc of type 1 fracture was better than type 3 (P = 0.006), the MEPS of type 1 fracture was better than type 2 (P = 0.009) and type 3 (P = 0.002). Conclusion: Open reduction and internal fixation with headless screw, Kirschner wire, and suture can be used for the treatment of comminuted distal humeral coronal shear fractures. The elbow joint function can be restored satisfactorily.

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Section: Prognosis Of Different Type Fracturessupporting

confidence: 93%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Treatment of Comminuted Coronal Shear Fracture of Distal Humerus

Teng

Zhong

2020

Orthopaedic Surgery

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“…Capitellum fractures, in particular type IV McKee fractures are especially rare in the paediatric population. They can also be associated with ligamentous injuries (lateral or medial collateral ligament lesions) or ipsilateral fractures (radial head fractures or epicondylar fractures of humerus) 5–9. The original paper by McKee et al 2 reports six type IV fractures including paediatric patients, treated by Open Reduction Internal Fixation (ORIF).…”

Section: Discussionmentioning

confidence: 99%

Type IV capitellum fractures in children

Papamerkouriou¹,

Tsoumpos

Tagaris

et al. 2019

BMJ Case Rep

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Capitellum fractures represent 1% of elbow fractures. A coronal shear fracture which involves the trochlea is classified as a type IV McKee fracture. The combination of its rarity in the paediatric population as well as its unique appearance on X-ray make diagnosis of this fracture a challenge. We present the case of a 14-year-old boy who sustained this fracture falling from his bike. It was diagnosed from the double arc sign on X-ray. In addition, a CT scan was obtained to aid preoperative planning. It was treated by open reduction and fixation with two headless compression screws. Follow-up at 6 months showed no avascular necrosis. The patient could achieve full extension, while flexion was reduced only by 5°. Final follow-up was conducted at 15 months. Anatomic reduction and stable internal fixation are essential for a good outcome in these uncommon paediatric fractures.

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“…3 They occur in both adults and children, with the elderly prone to more comminuted fractures. 4 The most common injury mechanism in females is a low energy fall onto an outstretched hand, particularly in older individuals. Higher energy fractures such as motor vehicle accidents or falls from height tend to occur in younger or male patient.…”

Section: Epidemiologymentioning

confidence: 99%

Coronal shear fractures of the distal humerus: Current concepts and surgical techniques

Watson¹,

Bellringer²,

Phadnis³

2019

Shoulder & Elbow

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Coronal shear fractures of the distal humerus are a unique subset of distal humeral fractures which entail partial or complete articular fractures of the distal humerus without involvement of the columns. The very distal nature of these fragments, their small size and propensity for comminution render them challenging to treat surgically. The purpose of this article is to describe the classification, outcomes and surgical techniques currently used for the treatment of these fractures using the available literature and authors' clinical experience.

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Distal humeral coronal plane fractures: management, complications and outcome

Cited by 30 publications

References 29 publications

Surgical Treatment of Comminuted Coronal Shear Fracture of Distal Humerus

Surgical Treatment of Comminuted Coronal Shear Fracture of Distal Humerus

Type IV capitellum fractures in children

Coronal shear fractures of the distal humerus: Current concepts and surgical techniques

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