Surgical Treatment Effect of Distal Humeral Shaft Fractures: A Prospective Cohort Study on Comparison of Lateral and Posterior Plating techniques

Abstract

Objective: The purposes of this study were to prospectively compare the clinical outcomes of distal humeral shaft fractures treated by lateral plating technique and posterior plating technique. Material and methods: From Jan 2017 to Aug 2019, fifty-one patients with distal humeral shaft fractures treated by lateral or posterior plating technique were collected. Patients were divided into two groups: the lateral plating group (group I, 28 patients) and the posterior plating group (group II, 23 patients). There was no statistical difference between the two groups in age, gender, injured arms, injury mechanism, AO/ASIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation ) classification and duration from injury to surgery (P > 0.05). Operation time, perioperative bleeding volume, hospitalization, complication rate were analyzed. Elbow function was assessed by the Mayo Elbow Performance Score (MEPS) and range of flexion and extension motion (ROM) was at last follow-up. Results: The mean duration of follow-up in group I was 14.25±1.818 months (range, 12–20 months), and was 15.26±2.717 months (range, 12–22 months) in group II. There was no significant difference in these items , including operation time, perioperative bleeding volume, AO/ASIF classification and hospitalization between the two groups (P > 0.05). Radiological and clinical evidence of bone healingwas seen in all patients. In group I, the mean union time was 13.00±0.41weeks (from10 to16weeks), the mean elbow ROM was 136.96/5.25° (range, 130-140° and 0-9°, respectively). In group II, the mean union time was 13.30±0.43 weeks (from10 to16 weeks), the mean elbow ROM was 138.52 /4.83° (range, 130-146° and 0-9°, respectively). The mean MEPS of lateral plating was 86.61±1.82 (from70 to100 points) and that of posterior plating was 85.87±1.88 (form70 to100points). No significant differences were found in union time, elbow ROM and MEPS between the two groups (P>0.05). The overall complication rate in group II was found to be higher than group I (P=0.014). Conclusions: Our results presented that both lateral and posterior plating techniques for distal humeral shaft fractures achieved satisfied treatment results; and lateral plating treatment with a lower complication rate .

Comparison of reconstruction of lateral femoral wall or not to operative effect of femoral intertrochanteric fracture treated with PFNA

“…The surgeon has rich experience in the application of reconstruction locking plate and PFNA, so the surgical incision, intraoperative blood loss and operation time have no signi cant increase (p>0.05). Zhang Tao et al [21] showed that PFNA has the advantages of short operation time, less intraoperative blood loss, simple operation, safety and reliability, and is an ideal internal xation method for intertrochanteric fractures. However, there is no internal xation device to reconstruct the lateral wall and x intertrochanteric fractures at the same time.…”