The use of parallel pre-contoured plates in the treatment of A and C fractures of the distal humerus

Abstract

The purpose of this study was to retrospectively evaluate the clinical and radiological results of fixation with parallel pre-contoured plates in intra-articular and extra-articular distal humerus fractures. We retrospectively evaluate seven cases of type A and six cases of type C fracture treated with the Mayo Clinic Congruent Elbow Plate system (Acumed, Hillsboro, Oregon) after a mean follow-up of 14.8 and 21.3 months, respectively. Mayo Elbow Performance Score (MEPS) was utilized for functional evaluation. Mean MEPS was (92.86 +/- 16.8) in the first group showing 6 excellent and one poor result, while (94.17 +/- 12) showing five excellent and one fair in the second group, showing no significant difference between the two groups (P = 0.87). The mean active motion recovered postoperatively was 120 degrees (+/-34.5 degrees) in type A fractures and 113 degrees (+/-14.7 degrees) in type C fractures, and there was no significant difference (P = 0.67). Complications occurred in 6 of the 13 patients analysed at follow-up (3 radial neuropathy, one ulnar neuropathy, one screw mobilization and one heterotopic ossification). The fractures healed in every patient, and no synthesis failed. The parallel plate system has proved to be extremely useful in the treatment of intra-articular and extra-articular distal humerus fractures. The pre-contoured geometry allows easier reduction and stabilization of complex fractures. The higher stability achieved permits early mobilization, thus obtaining a higher percentage of excellent results.

Comparative Study for Assessment of Functional Outcome of Intraarticular AO Type C Distal Humerus Fractures Treated by Parallel Plating

“…The mean MEPS score in our study was found to be 88.4; this result was superior to several studies 61617. A study by Rebuzzi et al 18 showed an average score of 94.17 which was higher as compared to our study, but this study had less number of cases ( n = 13). It was a retrospective study in comparison to our study which is a prospective study of 94 cases.…”

Distal Humerus Fractures

“…Multiple level IV series have reported satisfactory results with perpendicular plating techniques [30][31][32][33][34] and parallel plating techniques. [35][36][37][38][39][40] Several biomechanical studies have demonstrated that parallel plate configurations at 180° to each other are biomechanically superior to perpendicular plates when a gap model is used to simulate fracture comminution. [43][44][45] Two clinical level IV studies have reported on the results of locked plating of distal humerus fractures (n = 52 patients).…”

“…Level II • 1 study 27 Level III • 2 studies 28,29 Level IV • 20 studies [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] occurs following operative intervention for distal humerus fractures.…”

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

“…15 Schmidt-Horloh e et al followed up 51 patients with 52 mainly C-type (75.5%) fractures treated with 2 anatomically preshaped locking plates. 18 Results were excellent or good in 95.5% (Mayo Elbow Performance Score [MEPS], 87.5), mean extension deficit was 10 (11.4 in our study), and a stable fixation providing early physical therapy could be achieved in 73.1% of all fractures (82% in our study).…”