Outcomes of distal humerus diaphyseal injuries fixed with a single-column anatomic plate

Abstract

Purpose The locking compression extra-articular distal humerus plate (EADHP) is an anatomically shaped, angular stable single-column fixation system for distal third humerus fractures. The purpose of this retrospective study was to evaluate clinical and radiographic outcomes after open reduction and internal fixation of distal humerus fractures with this device. Methods Twenty-one consecutive patients with distal humerus fractures were treated with the EADHP system between February 2006 and June 2012. Of these, 19 were clinically and radiographically evaluated after a mean follow-up of 10.4 months. Follow-up assessment included anteroposterior and lateral radiographs, assessment of range of motion (ROM), pain according to a visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) score. Results All fractures demonstrated satisfactory reduction and healing at an average of 7.3 months. One patient showed postoperative sensory ulnar neuropathy that recovered completely, and nine patients had a preoperative radial nerve palsy, which recovered spontaneously following exploration and plating. Mean post-operative ROM was as follows: flexion 126°, extension −7°, pronation 82°and supination 83°. The VAS score was zero points in eight patients, while the mean DASH score was 25.8 points.Conclusions For extra-articular distal humerus fractures, including high-energy injuries often seen in gunshot wounds or motor vehicle injuries, the anatomically shaped angular stable single-column plate provides satisfactory clinical and radiographic results and serves as a valuable tool in the treatment of these injuries.

Functional outcome of extra-articular distal humerus fracture fixation using a single locking plate: A retrospective study

“…Recently, Meloy et al, 17 in a comparative study, contended that single-column plating with precontoured posterolateral locking plate results in comparable union rate and alignment in comparison to dual column plating for extra-articular distal humerus fracture but with (Table 2). [18][19][20][21] We feel that nonunion in our two cases (5.5%) were because of failure to achieve sufficient compression in anterior cortex, which may be partly due to plate configuration. The problem noted during application of plate on flat posterior aspect was offset of plate away from bone in proximal aspect; an attempt to approximate the plate close to the bone with the help of cortical screw leads to anterior opening of fracture site.…”

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

“…[1–3] Because nonoperative treatment of humeral shaft fracture may results in varus deformity and limitation of shoulder and elbow motion, there has been a trend toward operative treatment. [4–6] …”

Functional outcome of locking anatomical plate in extra articular fractures of the distal humerus

“…All these correlate with other similar studies conducted earlier. 6,21 In all our patients, the EADHP was used to fix the fracture. The plate length was selected so as to ensure 4 cortical screws in the proximal fragment.…”

“…In order to achieve stable, anatomical reduction and restoration of length, operative methods of treatment subsequently replaced conservative management of these fractures. [4][5][6][7] These operative techniques include intra medullary nail, 4.5 mm DCP and bi-columnar distal humerus plates. The intramedullary nail is difficult to insert due to the small size of medullary canal and small distal fragment.…”