Use of Orthogonal or Parallel Plating Techniques to Treat Distal Humerus Fractures

Abzug, Joshua M.; Dantuluri, Phani K.

doi:10.1016/j.hcl.2010.05.008

Cited by 12 publications

(5 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Knowing that bicolumnar plating is an effective and reliable method in treating complex distal humeral fractures [ 6 , 23 ], there is little evidence of the ideal plate positioning [ 24 , 25 ]. Especially the differences of orthogonal plating vs. parallel plating are discussed controversially in current literature.…”

Section: Discussionmentioning

confidence: 99%

Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome

Crönlein

Lücke

Beirer

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundManagement of distal humeral fractures remains to be one of the most challenging aspects in trauma surgery. Low profile plating systems with variable angle screw fixation represent a crucial advancement to the established angular stable locking plates with considerable attention in current research. The aim of the prospective randomized trial was to review the preliminary results and patients’ outcome following treatment with these newly developed implants and to rule out potential differences in fracture treatment of two different plating systems.MethodsTwenty patients with distal humeral fractures (AO 13-A1 – AO 13-C3) were included in the current study since 2014. After completing the randomization plan, patients were distributed into two groups for different variable angle locking plates (DePuy Synthes® VA-LCP vs. Medartis® Aptus Elbow). Functional elbow scoring (ROM, MEPS, QuickDASH) served as primary outcome parameter, while radiological fracture consolidation served as secondary outcome parameter. Follow-ups were conducted 6 weeks, 12 weeks, 6 months and 12 months after the operation.ResultsSeventeen of 20 patients (85%) concluded all follow-up examinations. Postoperative elbow extension deficiencies showed significant differences between the two groups in all follow-up examinations with a mean of Ø 18 +/− 7.4 degrees in the DePuy Synthes® VA-LCP group compared to a mean of Ø 6.5 +/− 7.5 degrees in the Medartis® Aptus Elbow group (p = 0.002) 12 months postoperatively. Functional scoring showed a disparate pattern. The Medartis® Aptus Elbow group achieved significantly better MEP scores during follow-up. However, the analysis of the QuickDash revealed better results of the DePuy Synthes® VA-LCP group in the first half and better results of the Medartis® Aptus Elbow group in the second half of the follow-up examination instead.ConclusionsConsidering the complexity of distal humeral fractures, the usage of anatomically preshaped low profile variable angle locking plates for operative treatment leads to good clinical results. Even though there might be some advances of the Medartis® Aptus Elbow plating system concerning postoperative ROM and elbow function, a consistent difference in the overall clinical outcome between the two plating systems could not be detected.Trial registration https://clinicaltrials.gov/ct2/show/NCT03272490 Retrospectively Registered 1. September 2017.

show abstract

Section: Discussionmentioning

confidence: 99%

Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome

Crönlein

Lücke

Beirer

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Hardware prominence decreases patient satisfaction and may cause pain during physiotherapy in the postoperative period. Further repeat surgeries are required in patients due to hardware prominence [9] . However, due to use of standardised 3.5mm precontoured locking plates, as put forth by the AO group, the incidence of hardware prominence was low.…”

Section: Follow Upmentioning

confidence: 99%

“…This method cannot be used in elderly patients with severe medical co-morbiditiesor those unfit for anaesthesia. Therefore, the current trend of management for distal humerus fractures is Open Reduction and Internal Fixation (ORIF) with bicolumnar plating to achieve anatomical reduction, maintainjoint congruity, maintain stable fixation of elbow joint and avoidance of complications [7,9] . In cases where it is difficult to do ORIF, like for fractures with significant comminution or in low lambda type (Mehne classification), it is suggested that Total Elbow Arthroplasty is a better alternative [10] .…”

Section: Introductionmentioning

confidence: 99%

To study the clinical outcome in distal humerus fractures with orthogonal plating via the olecranon osteotomy approach

Patil¹,

Mehta²,

Bhosale³

et al. 2020

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

The aim of our study was to evaluate the clinical outcome of distal humerus fractures treated with orthogonal plating via the olecranon osteotomy approach in the Indian population, at a tertiary care centre in Kolhapur. Method: A prospective study was carried out in a tertiary care center in Kolhapur. A total number of 16 patients with fractures of distal humerus (AO type B and C) were studied between May2019 to August 2020. All were treated with orthogonal plating via the olecranon osteotomy approach. A mean follow up of 6 months was carried out, and evaluation was done with the help of MEPS and DASH scoring system. Result: The mean radiological union time was 14.6 weeks with an arc of flexion of 101.2 degrees. The outcome measured using Mayo Elbow Performance Score (MEPS) and DASH scoring was 89 and 15.4 points respectively at 6 months. Patient satisfaction was 87% at the end of 6 month follow-up.25% patients reported complications like infection (1 patient), delayed wound healing (2 patients) and hardware prominence (1 patient). No cases of infection or peripheral neuropathies were reported in any of the patients. Conclusion:Orthogonal plating via the olecranon osteotomy approach remains a good alternative showing good clinical outcome in the treatment of distal humerus fractures (AO type B and C). It offers a more stable fixation and the olecranon osteotomy approach gives better exposure for surgery.

show abstract

“…All factors relating to the possibility of infection must be considered, such as type of wound, time of surgery, associated vascular injury and environment in which the wound occur. [15][16][17][18][19][20] If all factors are optimal, rigid internal fixation for these intraarticular fractures is advised when the wound is a Gustilo type I or type II. Secure fixation is a definite deterrent to infection in such wounds.…”

Section: Open Reduction and Internal Fixationmentioning

confidence: 99%

Surgical Management of Compound Distal Humerus Fracture by Jess External Fixator

Gupta¹,

Gupta²,

Aggrawal³

et al. 2014

jemds

View full text Add to dashboard Cite

BACKGROUND: Intraarticular displaced distal humerus fractures in adults always require open reduction and internal fixation with some plate and screw osteosynthesis after accurate reduction and alignment of fracture fragments. But high velocity trauma or gunshot injuries often lead to a compound fracture with contamination and devitalization of soft tissue cover which requires some kind of external fixation. We thereby report the outcome of a series of ten patients who were treated definitively by extensive debridement and JESS type external fixation. This external fixator construct gave excellent fracture fragment stability and early mobilization of elbow joint. It provided patient friendly definitive fixation assembly resulting in early fracture consolidation with reasonably good range of elbow movement for such difficult fractures. MATERIAL AND METHODS: Ten cases of compound intercondylar distal humerus fracture between January 2007 to December 2011were treated by early debridement & uniplanar bilateral JESS fixator application at the same sitting. This study includes cases of age group 18-65 yrs. of which 3 were females & 7 were males. Mean age was 31.5yr. Only one case had injury to elbow with Gunshot injury & rest were of high energy road traffic accidents. All patients reported within 40 hrs. average time to emergency department except 2 cases. A case of Gunshot injury reported after 5 days & one case reported after 7day with pus discharge wound. According to A.O. Classification, 4 cases with C 3 type& 6 were C 2 type. All cases were operated within a mean of 8.7hrs of presenting to the emergency department. The average interval between injury & operation was 48.7 hrs. RESULTS: Complete painless supination pronation movement was achieved in six weeks At the end of six months of aggressive physiotherapy, the average extension was 9 degrees (range = 5-15 degrees) and average flexion was 106 degrees (range = 70-120 degrees). Clinical evaluation of elbow functions was done at sixth month using Mayo elbow score where 20% excellent, 60% good, 10%fair and10% poor results were obtained. CONCLUSION: This is a relatively new technique of fixing compound intra-articular distal humerus fractures with JESS external fixator without spanning and immobilizing elbow joint has given good results, good patient compliance, least complications in our series of ten cases.

show abstract

Use of Orthogonal or Parallel Plating Techniques to Treat Distal Humerus Fractures

Cited by 12 publications

References 33 publications

Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome

Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome

To study the clinical outcome in distal humerus fractures with orthogonal plating via the olecranon osteotomy approach

Surgical Management of Compound Distal Humerus Fracture by Jess External Fixator

Contact Info

Product

Resources

About