J Korean Fract Soc.  2010 Apr;23(2):194-200. 10.12671/jkfs.2010.23.2.194.

Double Parallel Plates Fixation for Distal Humerus Fractures

Affiliations
  • 1Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. hsgong@snu.ac.kr

Abstract

PURPOSE
The purpose of this study was to review the outcome of fixation of distal humerus fractures using recently-introduced double parallel plate system in sagittal plane.
MATERIALS AND METHODS
From May 2004 to June 2008, seventeen patients with distal humerus fractures underwent primary open reduction and internal fixation with double parallel plates. According to the AO classification, there were 2 A3, 2 C1, 7 C2, and 6 C3 type fractures. Outcome assessment was performed by using the Mayo Elbow Performance index (MEPI).
RESULTS
At a mean follow up of 18 (range, 12 to 32) months, 4 patients were rated as excellent, 8 as good, and 5 as fair in terms of MEPI. The average arc of elbow flexion after primary operation was 116 (range, 90~140) degrees with a mean flexion contracture of 13 (range, 0 to 30) degrees. One patient required reoperation due to fixation failure and six patients underwent capsulolysis and three patients underwent ulnar nerve neurolysis. The time to begin elbow motion exercise had negative correlation with total elbow range of motion and multiple trauma patients had significantly lower MEPI functional score compared to those without combined injury.
CONCLUSION
Double parallel plating allowed adequate fixation for distal humerus fractures regardless of patient age and fracture pattern. Partial ankylosis and unlar nerve compression symptoms were the main causes of reoperation.

Keyword

Distal humerus fracture; Double plate; Parallel plate

MeSH Terms

Ankylosis
Contracture
Elbow
Follow-Up Studies
Humans
Humerus
Multiple Trauma
Range of Motion, Articular
Reoperation
Ulnar Nerve

Figure

  • Fig. 1 (A) Anteroposterior and lateral radiograph of elbow in a 31-year-old women show intra-articular fracture of distal humerus. (B) 3-dimensional CT shows AO/ASIF C3 type fracture of distal humerus. (C) Postoperative anteroposterior and lateral radiograph.

  • Fig. 2 (A) Anteroposterior and lateral radiograph of elbow in a 62-year-old women show intra-articular fracture of the distal humerus. (B) 3-dimensional CT shows AO/ASIF C2 type fracture of distal humerus. (C) Initial postoperative anteroposterior and lateral radiograph. (D) At fifteen days after initial operation, the patient slipped down and came to the clinic complaining the elbow pain. Radiographic images show fixation failure of the distal humerus. (E) Postoperative radiographs after second operation.


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