Outcome of type C (AO) distal humeral fractures: follow-up of 22 patients with bicolumnar plating osteosynthesis

Puchwein, Paul; Wildburger, R.; Archan, Sylvia; Guschl, Martin; Tanzer, Karin; Gumpert, Rainer

doi:10.1016/j.jse.2010.12.019

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…In this study, patients’ satisfaction level was 93%. In another study by Puchwein et al .,[ 12 ] in 2011, 22 patients who had undergone surgery for Type C fractures of humerus between 1999 and 2008 were evaluated retrospectively. In this study, JUPITER, CASSEBAUME, and Quick DASH tools were utilized to evaluate surgery outcomes.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Outcomes of Open Reduction and Internal Fixation Surgery in Patients with Type C Distal Humeral Fractures

2018

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Background:In this study, functional state of patients with Type C distal humerus fractures undergone surgical plating was evaluated 6 and 12 months after the surgery in order to record postsurgical factors such as pain level and job/performance satisfaction.Materials and Methods:In this cross-sectional study, 46 patients with humerus fractures were recruited and their ability to do daily tasks, presence of degenerative changes, stability of elbow joint, and range of motion was evaluated. For assessment of response to surgery, Mayo score was used.Results:Among 46 patients, 45 (97.8%) of them had joint stability. Evaluation of postsurgical complications showed that six subjects (13%) had no complications, but superficial infection was observed in 12 (26.1%) subjects. Neuromuscular disorders in ulnar nerve were present in 11 subjects (23.9%), recurrent articular bursitis of elbow joint in 6 subjects (13%), stiffness of elbow joint in 29 subjects (63%), nonunion of fracture in 3 subjects (6.5%), and myositis ossification in 4 (8.7%) subjects. Furthermore, 18 (39.1%) patients presented with more than one (2–4) complications.Conclusion:Open reduction and internal fixation surgery with dual plating is the method of choice for treatment of Type C distal humeral fractures. Evaluation of long-term outcomes of this surgery could be done via several different questionnaires as many studies suggest. This study demonstrated that the outcomes of this surgery in Isfahan, Iran, have been noticeably inferior compared to results of the studies in other parts of the world.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Outcomes of Open Reduction and Internal Fixation Surgery in Patients with Type C Distal Humeral Fractures

2018

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“…Although intraarticular distal humerus fractures are rare, they present a clinical challenge for orthopaedic surgeons due to the complex anatomy of the distal humerus and difficulty in exposing the fracture. The main surgical goal of fixation of such fractures is to achieve a stable joint with a good range of pain free movement [1][2][3][4][5] . Many fixation methods have been proposed; the use of K-wires, screw fixations, Y-shaped plates, single plates and double plates.…”

Section: Discussionmentioning

confidence: 99%

“…Many fixation methods have been proposed; the use of K-wires, screw fixations, Y-shaped plates, single plates and double plates. Among them the dual plating osteosynthesis through a posterior approach with an olecranon osteotomy is now considered an acceptable treatment modality [1][2][3][6][7][8][9] , It offers excellent posterior visualization of the distal humerus, without any untoward effect on triceps strength and postoperative rehabilitation [6][7][8][9][10][11][12][13][14] . Recently many national and international studies have focused attention on the importance of surgical approach and stable fixation for early elbow mobilization [1][2][3][4][5][6][7][8][9][10][11][12][13][14]18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…Inter-condylar distal humerus fractures (DHF) in adult is one of the most problematic fracture that requires not only accurate reduction of the articular surface and restoration of fracture anatomy of the distal humerus but also require a rigid fixation of the fracture fragments to enable early postoperative mobilization [1][2][3][4][5] A number of techniques have been used to treat such inter-condylar DHF in adult; all of them, fixation with dual plating through posterior approach with an olecranon osteotomy is now considered an accepted treatment modality [1][2][3][6][7][8][9] . Recently several authors have pointed out the importance of surgical approach, rigid fixation and early elbow mobilization for good [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . This method of fixation provides rigid fixation; while use of posterior approach with olecranon osteotomy minimize the risk of triceps injury thus allowing early post-operative rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

2017

J Liaquat Uni Med Health Sci

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INTRODUCTION: The dual plate osteosynthesis technique for fixation of inter-condylar distal humerus fracture is now considered an accepted treatment modality. It provides a rigid fixation of fracture fragments to enable early post-operative mobilization for good outcome. OBJECTIVE: The purpose of study is to assess the morbidity and clinico-radiological outcome of the dual plating osteosynthesis technique used for fixation of inter-condylar distal humerus fractures (DHF) via trans-olecranon approach METHODOLOGY: This perspective cross sectional study was carried at Department of Orthopaedic Surgery, Dow Medical College / Civil Hospital Karachi from June 2014 to March 2016. A total of 21adult patients with comminuted inter-condylar fracture of the distal humerus operated with dual plating osteosynthesis technique via trans-olecranon approach were evaluated clinically and radiologically for functional outcome based on Jupiter criteria including alignment and fracture union after a mean follow-up of 8 months. Post surgical complications were noted. Fractures were classified according to Muller et al (AO). Patients with polytrauma, pathological fracture, open fracture and a fracture more than 2 week old were excluded from the study. RESULTS: Out of the 21 patients, 38% were female and 62% were male. 52.3% had left elbow while 47.6% had right elbow involvement. The mean age was 31 years (range 20-50 years). Mean time between injury and internal fixation was 4.8 days. The mean follow-up period was 8 months. As per AO classification, 10 cases were C1, 7 cases C2 while 4 cases were in C3. The most common cause of fracture was road traffic accident in 13 cases. All fractures achieved anatomical restoration of articular surface and were united in average 14.6 weeks. The clinical results were evaluated for functional outcome based on Jupiter criteria. According to that criterion, satisfactory results were obtained in all patients. We had no instance of postoperative deep infection and neurological complications, only Backing of olecranon K-wires were noted in 5 patients (23.8%). CONCLUSIONS: We conclude that dual plate osteosynthesis technique is an effective procedure for fixation of inter-condylar distal humerus fracture, achieves rigid fixation and hence, early mobilization. Additionally use of olecranon osteotomy offers best fracture exposure of distal humerus. Complications were minimal and healing satisfactory.

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“…Despite this, reported results in the last decade have shown good results with regard to union rates, range of motion, and functional outcome scores at mid- to long-term follow-up. 1–4 However, reoperation rates have been high in multiple case series, particularly as it relates to infection, stiffness, and need for hardware removal. 1,2,5–12…”

Section: Introductionmentioning

confidence: 99%

Predictors of reoperation after internal fixation of intra-articular distal humerus fractures

et al. 2020

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Background Despite good reported outcomes with open reduction and internal fixation of intra-articular distal humerus fractures, complication rates remain high. The objective of this work is to identify factors associated with reoperation. Methods Sixty-three patients treated with open reduction and internal fixation for intra-articular ( Arbeitsgemeinschaft für Osteosynthesefragen type C) distal humerus fractures between 2004 and 2010 were identified using an institutional trauma registry, 62 of which were followed for a minimum of six months. Age, gender, fracture subclassification, open fracture presence, Injury Severity Score, time to definitive surgery, length of postoperative immobilization, and type of approach were recorded. Multivariate analysis was utilized to identify factors independently associated with reoperation. Results Complications requiring reoperation developed in 25 (40.3%) elbows. The most common reasons were wound dehiscence or infection in nine elbows (14.5%) and symptomatic hardware in six (9.6%). During multivariate analysis, only olecranon osteotomy remained an independent predictor for reoperation ( P = 0.043). Discussion Despite improved internal fixation techniques, a high proportion of elbows require reoperation after open reduction and internal fixation for distal humerus fractures. Higher complication rates in fractures fixed through an olecranon osteotomy may reflect additional reoperations due to nonunion of the osteotomy or need to remove hardware from the ulna. Level of evidence Prognostic Level III.

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Outcome of type C (AO) distal humeral fractures: follow-up of 22 patients with bicolumnar plating osteosynthesis

Cited by 11 publications

References 17 publications

Evaluation of Outcomes of Open Reduction and Internal Fixation Surgery in Patients with Type C Distal Humeral Fractures

Evaluation of Outcomes of Open Reduction and Internal Fixation Surgery in Patients with Type C Distal Humeral Fractures

Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

Predictors of reoperation after internal fixation of intra-articular distal humerus fractures

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