Journal of Musculoskeletal Trauma

Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus: Chul Hyung Lee, Doo Hun Sun, Deukhee Jung, Chung Han An; J Korean Fract Soc 2019;32(3):128-134. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.128

Abstract PDF: PURPOSE
The aim of this study was to determine the outcomes of fixation of AO/OTA type C2 fractures among intra-articular fractures of the distal humerus using the paratricipital approach (side to side retraction of the triceps).
MATERIALS AND METHODS
From June 2008 to January 2018, 12 patients underwent an open reduction and internal fixation with the paratricipital approach and were followed-up for more than 10 months after surgery. According to the AO/OTA classification, type C2 fractures were chosen among the intraarticular distal humerus fractures. An extended posterior incision was used over the olecranon in the prone position, preserving the insertion site of the triceps brachii muscle. The fracture site was exposed by retracting the muscle side-to side through a dissection of the medial and lateral intermuscular septum of the triceps brachii muscle. The therapeutic results were assessed by the anatomical reduction of the articular surface and integrity of the metaphyseal contour in postoperative simple radiographs, complications, such as neuropathy or non-union, and the Mayo elbow performance score (MEPS) were checked to estimate the functional outcome.
RESULTS
In the postoperative simple radiographs, no case showed more than 1 mm step-off and the disrupted contour of the distal humerus was recovered to normal alignment in most cases. The range of elbow joint motion in the last follow-up was 133.8Â° on average with a mean flexion contracture of 5.0Â°. The clinical results depending on the MEPS were excellent, except for two cases, which were good. Neuropathy of the ulnar nerve was observed in one patient, which was resolved after metal removal.
CONCLUSION
The paratricipital approach is useful technique in AO/OTA type C2 intra-articular distal humerus fractures that provides sufficient exposure of the surgical field, without injury to the triceps brachii muscle and postoperative complications associated with the trans-olecranon approach.

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Posterior Dual Plating for Distal Shaft Fractures of the Humerus: Chul Hyun Cho, Kwang Yeung Jeong, Beom Soo Kim; J Korean Fract Soc 2017;30(3):117-123. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.117

Abstract PDF: PURPOSE
To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus.
MATERIALS AND METHODS
We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs.
RESULTS
Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery.
CONCLUSION
Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.

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Results of Treatment for Medial Condyle Fracture of the Distal Humerus in Children: Jeong Han Kang, Seung Hyeon Yang, Kuk Pil Lim, Hui Taek Kim; J Korean Fract Soc 2013;26(4):261-267. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.261

Abstract PDF: PURPOSE
We evaluated outcomes of treatment in medial condyle fracture of the distal humerus in children.
MATERIALS AND METHODS
Seven patients (4 females, 3 males) who were treated at the Pusan National University Hospital and followed-up until skeletal maturity after treatment were included. The average age at the time of fracture was 4.6 years (range, 2 to 10 years). Treatment was performed from 1 day to 6 months after the fracture: 4 patients underwent a surgical treatment for 17 days, 2 months, 2 months and 6 months after fracture, respectively. All fractures were Milch type 1. Five patients had Kilfoyle type 3, and two patients had type 2 fractures. Final outcomes were evaluated by the Mayo elbow performance score and carrying angle.
RESULTS
There were 3 excellent, 3 good and 1 fair result at the final follow-up. There was no elbow pain in any of the patients. One of the four patients who underwent a late surgical treatment received corrective osteotomy due to cubitus varus. All four patients had a limitation of elbow motion. The other three patients who had accurate diagnosis and treatment had a full range of motion.
CONCLUSION
Diagnosis of medial condyle fracture of the distal humerus based on plain radiograph is difficult in children due to its cartilaginous structures. When a patient shows pain, tenderness and swelling on the medial side of the elbow, an additional examination with magnetic resonance imaging may be required even if no fracture line is found in the radiograph. Accurate diagnosis and early treatment is important for good results.

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Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures: Yoon Min Lee, Seok Whan Song, Ki Bum Choi, Yoo Joon Sur, Sung Eun Kim; J Korean Fract Soc 2013;26(4):254-260. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.254

Abstract PDF

PURPOSE
Fractures of the distal humerus are one of the challenging injuries due to its complex anatomy and accompanied comminution. For dual plate fixation, orthogonal or parallel plating is widely used, but the better of the two is debatable. The purpose of this study was to report another fixation technique that yielded good clinical results with early bone union of distal humerus fracture, namely, posterior-posterior plate fixation.
MATERIALS AND METHODS
From March 2003 to March 2012, 20 patients with distal humerus fractures were treated by posterior-posterior plate fixation. The triceps reflecting approach was used with anterior transposition of the ulnar nerve. The mean age at the time of injury was 45 years (range, 26 to 78 years). By AO classification of distal humerus fractures, there were one case of A2 and B3 respectively, two cases of each A3, C1 and C3, and twelve cases of C2.
RESULTS
The mean period of complete bone union was 7.1 weeks (range, 4 to 11 weeks). The mean flexion-extension range of motion of the elbow joint at last follow-up was 116.2 degrees. The mean pronation was 81.2 degrees and supination was 83.1 degrees. Plates and screws were removed at about nine months after the initial surgery. No cases showed complications or required additional operation.
CONCLUSION
Posterior-posterior dual plates fixation resulted in stable bicortical screw fixation, and insertion of lag screws were possible without interference. Posterior-posterior plating could be an easy and stable fixation method that provides good clinical results.

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Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study
Chien-An Shih, Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Cheng-Li Lin, Ming-Long Yeh, Wei-Ren Su
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef

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Treatment of Non-union Distal Humerus Fractures after Operation: Hyung Sik Kim, Ki Joon Jang, Yun Rak Choi, Il Hyun Koh, Ho Jung Kang; J Korean Fract Soc 2012;25(4):310-316. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.310

Abstract PDF

PURPOSE
This study is a retrospective analysis of patients who had undergone surgical treatment for non-union of distal humerus fracture. We evaluated them in terms of causes of injury, radiologic findings, and clinical outcomes such as prognosis.
MATERIALS AND METHODS
Seven consecutive radiologic patients who were confirmed to have nonunion of a distal humerus fracture underwent reoperations. These patients had already undergone operations for distal humerus fractures. This survey was held from 2005 to 2010. The average period up to diagnosis of non-union after the first operation was 7.4 months (4 to 16 months). The mean follow-up period was 24.6 months (12 to 65 months). Each patient was graded functionally according to the Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand Score.
RESULTS
Osteosynthesis was performed by internal fixation with plates and screws and then a bone graft for non-union of the distal humerus fracture. The average range of motion within the elbow joints was found to be a flexion contracture of 18.8 degrees (0~30 degrees) and further flexion of 120.2 degrees (102~140 degrees). Among postoperative complications, three cases of medium-degree stiffness, two cases of medial column nonunion, and one case of dissociation of the internal fixator were reported.
CONCLUSION
Stable internal fixation for maintenance reduction status is essential after accurate initial anatomical reduction. We concluded that nonunion could be prevented by additional surgical treatment such as autogenous bone graft, if it is necessary.

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Autogenous Inlay Bone Graft for Distal Humerus Nonunion with Metaphyseal Bone Defect: A Technical Note
Yong-Suk Lee, Dongmin Kim, Min-Sung Kang, Jong-Hwa Park, Sang-Uk Lee
Archives of Hand and Microsurgery.2020; 25(1): 39. CrossRef

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Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating: Joong Bae Seo, Jae Sung Yoo; J Korean Fract Soc 2011;24(3):243-248. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.243

Abstract PDF: PURPOSE
To analyze the results of operative treatment for Comminuted Fracture of Distal Humerus with Transolecranon approach and Orthogonal plating.
MATERIALS AND METHODS
The subjects were 22 patients with Comminuted fracture of humerus who were treated with Orthogonal plating. Patient's age, sex, type of fracture, surgical approach, method of fixation, time of operation, time of bony union, complication, range of motion were investigated, and Function of elbow was evaluated by functional evaluation of Riseborough and Radin, Mayo Elbow Performance Score (MEPS).
RESULTS
Age, sex, injuried arm, operation time were not related to postoperative result. Type C2 fractures showed better results in function and range of motion (ROM) than type C3 fractures. Also early rehabilitation was important to functional recovery and ROM. The postoperative ROM was average 110. Good were 16 cases, fair were 6 cases in functional evaluation of Riseborough and Radin. Excellent were 13 cases, good were 8 cases, fair was 1 case in MEPS.
CONCLUSION
Operative treatment with Transolecranon approach and Orthogonal plating showed favorable result on its function. Intraarticular comminution and early rehabilitation were closely related to postoperative function of elbow.

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture: Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung; J Korean Fract Soc 2010;23(2):201-205. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.201

Abstract PDF

PURPOSE
To evaluate functions of the elbow joint according to surgical approach, time to exercise, and type of fracture after surgical treatment for the intra-articular comminuted fracture of the distal humerus.
MATERIALS AND METHODS
27 patients with the intra-articular comminuted fractures of the distal humerus underwent surgery from March, 2000 to January, 2007. We investigated the surgical approach, time for union, time to exercise and age. We also evaluated postoperative functions of the elbow joint according to the flexion contracture, the range of motion and the Mayo elbow performance score.
RESULTS
The average follow-up period was 37 months and the average time for union was 14 weeks. The average range of flexion was 115 degrees, the average flexion contracture was 10 degrees, and the Mayo elbow performance score with average value of 85 point showed good clinical results. There were no statistically significant differences in functions of the elbow joint according to the operative method and age. However, patients with early postoperative exercise within 6 days showed statistically better outcomes than patients with postoperative exercise after 7 days. Type C1, 2 fractures showed statistically better results than the type C3 fracture.
CONCLUSION
Stable fixation and early exercise are required to prevent postoperative complications and restore functions of the elbow joint with an intra-articular comminuted fracture of the distal humerus.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef

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Double Parallel Plates Fixation for Distal Humerus Fractures: Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk Jin Lee, Joon Oh Lee, Kyu Won Oh, Hyun Sik Gong; J Korean Fract Soc 2010;23(2):194-200. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.194

Abstract PDF: 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.

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Treatment of Intercondylar Fracture of Distal Humerus in Adult: Kyung Won Song, Seung Yong Lee, Sung Il Shin, Jin Young Lee, Kab Rae Kim, Hyung Seok Oh, Jin Duck Kim, Dae Eun Choi; J Korean Fract Soc 2006;19(1):62-66. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.62

Abstract

PURPOSE
To evaluate and report the clinical results of the treatment of distal humerus intercondylar fractures treated with internal fixation through the modified posterior approach.
MATERIALS AND METHODS
From January 1999 to October 2003, 20 patient who had intercondyle fracture of the distal humerus treated with internal fixation through the modified posterior approach. We evaluated bone union, complication, postoperative elbow function.
RESULTS
The average follow up period was 12.8 months. Nearly all most cases united at 14 weeks in an average. There were two neuropraxia and two hardware failure. The range of the elbow joint motion was flexion contracture 8 degree (5~15 degree) to further flextion 120 degree (75~140 degree) in average. The functional result with Riseborough and Radin's functional scale were as follows; 13 good, 4 fair, 3 poor.
CONCLUSION
Not with severe comminuted like type C3 fracture, but in cases with intercondylar distal humerus fracture the modified posterior approach provided satisfactory exposure for open reduction and rigid internal fixation with satisfactory bone union. There was satisfactory bone union and good clinical result in postoperative elbow function.

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Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Elbow Function and Complications after Internal Fixation for Fractures of the Distal Humerus: Hyug Soo Ahn, Young Ho Cho, Young Soo Byun, Do Yop Kwon, Seung Oh Nam, Dong Young Kim; J Korean Fract Soc 2006;19(1):56-61. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.56

Abstract

PURPOSE
To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures.
MATERIALS AND METHODS
We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al.
RESULTS
Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures.
CONCLUSION
To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.

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Comparison of Shoulder Range of Motion, Pain, Function, Scapular Position Between Breast Cancer Surgery and Shoulder Surgery Female Patients
Min-ji Lee, Suhn-yeop Kim, Jae-kwang Shim
Physical Therapy Korea.2015; 22(1): 9. CrossRef
Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate
Hyoung Keun Oh, Suk Kyu Choo, Jung Il Lee, Dong Hyun Seo
Journal of the Korean Fracture Society.2012; 25(4): 305. CrossRef
Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft - A Case Report -
Jin Rok Oh, Chang Ho Lee, Ki Yeon Kwon, Hoi Jeong Chung
Journal of the Korean Fracture Society.2010; 23(1): 118. CrossRef
Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Triceps-Sparing Posterior Approach for Intra-articular Fracture of Distal Humerus: Suk Ha Lee, Sung Tae Lee, Jin Young Park, Jung Sup Keum, Jong Ryun Baek, Kwang Jun Oh; J Korean Fract Soc 2006;19(1):51-55. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.51

Abstract: PURPOSE
To evaluate the therapeutic results of intra-articular fracture of distal humerus treated through triceps sparing posterior approach.
MATERIALS AND METHODS
From February 2001 to December 2003, we reviewed total 9 cases of intra-articular fracture of distal humerus, which were treated by surgical treatment and were followed more than for 12 months. According to the OTA classification, nine cases were classified as type A; two, as type C1; five, as type C2; two. Triceps sparing posterior approach was used in all nine patients. An extensile posterior incision was used over the olecranon without triceps muscle injury. Exposure of the fracture site was done by obtaining medial-lateral mobility through dissection of medial and lateral edge of triceps muscle. Therapeutic results were assessed by bone union, duration for fracture union, complication. and for functional estimation, Mayo elbow performance score was checked and analysed.
RESULTS
The range of the elbow joint motion was flexion contracture 5.2 degree to further flexion 135.5 degree on average. Clinical results using Mayo elbow performance score were as follows; six excellent, three good. Compressive neuropathy of ulnar nerve which has been done anterior transposition was observed in one patient.
CONCLUSION
Triceps sparing posterior approach is useful surgical technique that provides sufficient exposure of medial and lateral condyle without injury of triceps muscle in intra-articular fracture of distal humerus to the extent of OTA type C2.

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Intercondylar Fracture of Distal Humerus in Children: Woo Suk Lee, Whan Yong Chung, Woo Sik Kim, Yong Chan Kim, Taek Soo Jeon, Nam Hyun Kim, Kyoo Tae Kim; J Korean Fract Soc 2004;17(4):380-383. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.380

Abstract PDF

Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

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Adolescent Distal Humerus Fractures: ORIF Versus CRPP
Phillip Bell, Brian P. Scannell, Bryan J. Loeffler, Brian K. Brighton, R. Glenn Gaston, Virginia Casey, Melissa E. Peters, Steven Frick, Lisa Cannada, Kelly L. Vanderhave
Journal of Pediatric Orthopaedics.2017; 37(8): 511. CrossRef

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Modified Step-cut Osteotomy of Distal Humerus for the Correction of Cubitus Varus Deformity in Children: Yeo Hon Yun, Jun Gyu Moon, Duk Moon Chung; J Korean Fract Soc 2004;17(3):287-294. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.287

Abstract PDF: PURPOSE
evaluate the radiologic and clinical results of modified step-cut osteotomy for correction of cubitus varus deformity in children.
MATERIALS AND METHODS
We analysed 16 children who had varus deformity preoperatively and received modified step-cut osteotomy. The results were evaluated by final follow-up radiographs and clinical results, which were humeral-elbow-wrist angle, lateral prominence, range of motion and complications.
RESULTS
The average preoperative humeral-elbow-wrist (HEW) angle was -15.8degrees and average last follow-up HEW angle was +6.7degrees Lateral prominence under 5 mm occurred in 3 cases and one children showed limited motion and transient ulna neuropathy.
CONCLUSION
The results demonstrate that modified step-cut osteotomy achieve good correction of cubitus varus without lateral bony prominence or complications.

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Treatment in Distal Humerus Fracture with Anatomical Y Plate: Eun Sun Moon, Sung Man Rowe, Jong Keun Seon, Myung Sun Kim, Seong Beom Cho; J Korean Fract Soc 2004;17(2):76-82. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.76

Abstract PDF

PURPOSE
To evaluate the clinical results of this modified anatomical Y-plate in treatment of distal humerus fracture and factors that affect the results.
MATERIALS AND METHODS
From April 1991 to January 2002, 40 cases (16 male, 24 female) of distal humeral fractures were treated using a modified anatomical Y plate. The patient's age, gender, pain, range of motion, instability, function, bone union, and complication were recorded.
RESULTS
At the operation, the mean age of patients is 49.5 years (12~74 years) and mean follow up period is 18 months (13~82 months). In the range of motion, mean flexion is 122.1 degrees (75~140 degrees) and mean flexion contracture is 11.4 degrees (0~30 degrees). Results by Morrey's functional evaluation include 15 excellent, 23 good and 2 fair cases. There are 2 excellent and 5 good cases in patients of supracondylar fracture which didn't involve the articular surface (A2, A3 type of AO classification), and 13 excellent, 18 good and 2 fair cases in patients of intracondylar fracture which involve the articular surface (B2, C1, C2, C3 type). But there is no statistical significance in results between two groups. There are 3 excellent, 3 good cases in 6 open fracture and 2 excellent, 6 good and 1 fair case in 9 patients with multiple trauma. The patient's age, gender, open fracture, multiple trauma, and intraarticular fracture did not affect the results.
CONCLUSION
Satisfactory results can be obtained if the modified anatomical Y-plate is used to treat a distal humerus fracture, regardless of many factors affecting the results.

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Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture
Hugo Barret, Romain Ceccarelli, Paul Vial D’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Orthopaedics & Traumatology: Surgery & Research.2023; 109(5): 103380. CrossRef
Étude comparative d’une plaque verrouillée anatomique et innovante en Y par rapport à 2 plaques à 90 degrés pour la prise en charge des fractures supra condyliennes de l’humérus
Hugo Barret, Romain Ceccarelli, Paul Vial d’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Revue de Chirurgie Orthopédique et Traumatologique.2023; 109(5): 648. CrossRef
Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Opreative Treatment of Intra-articula T or Y: Young Kyu Kom, Gi Serk Eom; J Korean Soc Fract 2000;13(2):303-310. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.303

Abstract PDF

PURPOSE
: To evaluate the results after rigid fixation for intraarticular distal humerus fractures and determine the prognostic factors influencing outcome.
MATERIALS AND METHODS
: Twenty-two patients were managed with the rigid fixation using dual plate or one plate combined with cannulated screw. According to the M ller's classification, eleven cases were classified as type C1; five, as type C2; and six, as type C3. Based on the age, the patients were divided into two groups as a guideline of 50 years so that the number of the patients was 11 cases respectively. RUSULTS : By the rating scale from Aitken and Rorabeck, excellent or good results were 90% in type C1, 80% in type C2 and 66% in type C3. All patients who were under 50 years of age obtained excellent or good results, and group who were older than 50 showed 64% good results.
CONCLUSION
: Rigid fixation using dual plate and early mobilization using functional brace were considered to be a good method for intraarticular distal humerus fractures. And, this study revealed that comminution of fracture and age became an important factors in achieving the desire results.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus
Ji-Kang Park, Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho
Journal of the Korean Fracture Society.2012; 25(2): 129. CrossRef

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Refracture of Forearm Bone after Plate Removal: Sung Keun Sohn, Byeong Hwan Kim, Sang Ki Lee; J Korean Soc Fract 2000;13(1):132-138. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.132

Abstract PDF

PURPOSE
: To evaluate the results of operative treatment for intercondylar fracture of the distal humerus in adults.
MATERIALS AND METHODS
: From February 1994 to June 1998, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 12 of them were treated by open reduction and internal fixation(dual plate for 8, screw & K-wire for 4) and 3 of them by open reduction & Ilizarov fixation. Open or closed fracture and AO classification of fracture were considerd as a prognostic factor. The functional results were analyzed by Jupiter's critera.
RESULTS
: There were 2 excellent, 2 good in C1 type, one excellent, 2 good, one fair and 2 poor in C2 type, and one excellent, 2 good, 2 poor in C3 type. And there were one good and one poor in 2 open fractures and 4 excellent, 5 good, one fair and 3 poor in closed fractures. The average range of motion of the elbow joint was 85 degrees(30 degrees-115 degrees). Overall results show excellent and good in 67%(10 of 15) and poor in 27%(4 of 15).
CONCLUSION
: It's not easy to get satisfactory results in treatment for intercondylar fracture of the distal humerus We suggest that more efforts are needed to get anatomical reduction, rigid internal fixation and early joint motion in interconylar fracture of the distal humerus.

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Refractures of the Upper Extremity in Children
Hui Wan Park, Ick Hwan Yang, Sun Young Joo, Kun Bo Park, Hyun Woo Kim
Yonsei Medical Journal.2007; 48(2): 255. CrossRef

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Dual Plate Osteosynthesis for Distal Humeral Fractures: Chang Wu Oh, Hee Soo Kyung, Pook Taek Kim, Il Hyung Park, Yeong Chul Choi; J Korean Soc Fract 2000;13(1):120-125. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.120

Abstract PDF: PURPOSE
: The purpose of this pater was to evaluate results of double plate osteosynthesis in distal humerus fractures. MATERIAL AND METHOD : From June1995 to August 1998, we reviewed 22 distal humerus fractures. According to the type of fractures(AO classification), 6 and 16 cases were type A and C respectively. According to surgical approach, transolecranon approach was done in 12 cases and triceps split approach in 10 cases. We fixed intercondylar fracture with lag screw and supracondylar fracture with dual plate(2 reconstruction plates or 1 reconstruction plate + 1/3 tubular plate) as right angle. Rehabilitation was started just after postoperative 24 hours with posterior splint, and then increase activity and frequency.
RESULTS
: Average union time was 11.5 weeks. Overall functional results according to the classification of Jupiter and Cassebaum were excellent, good, fair, poor in 8, 10, 3, 1 cases, respectively. According to the age, patients under 50-year-old group revealed slightly superior functional. According to the type of fracture, surgical approach, interval between injury and approach, there were no statistically significant difference between group(p>0.05). There were 5 cases with complications. 1 case was mental failure, 3 cases were ulnar palsy, and 1 case was transient radial nerve palsy.
CONCLUSION
: We consider dual plate osteosynthesis in distal humerus fractures as a good treatment modality, even in type C fractures and old age patients.

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Operative Treatment of Intraarticular Fracture of Distal Humerus in Adults: Hyon Oh Cho, Kyoung Duck Kwak, Soo Min Sohn, Woo Keun Jeong, Jong Cheong Choi; J Korean Soc Fract 1999;12(4):975-980. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.975

Abstract PDF: The fractures around the elbow joint in adults are relatively rare in comparision with that in childeren, but the late complications are more common in adults. We have clinically and radiologically analyzed 14 cases of fractures around the elbow joint in adults from January 1995 to December 1998. All patients were treated by open reduction and application of medial and lateral bottress plates providing stable internal fixation enhance early motion. The patients were evaluated for range of motion, infection, pain, degenerative changes. The 14 patients were available for follow-up study for average of 12 months. The result were good in nine, fair in two, poor in three. Traetment of choice for the type III and IV of distal humerus fracture is open reduction with stable internal fixation with plates combined with early active motion.

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Fracture-Separation of The Distal Humeral Epiphysis: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Seung Joon Shin, Jeong Tae Kim; J Korean Soc Fract 1998;11(3):650-657. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.650

Abstract PDF: A fracture-separation of the distal humeral epiphysis in children is an extremely rare injury and presents problems in diagnosis, radiographic interpretation and management. From June 1992 to December 1996, Authors experienced the 5 cases of Salter - Harris type II injury of the distal humeral epiphysis at Department of Orthopedic Surgery, Pusan Maryknoll General Hospital. The patient were followed up from one year nine months to three years four months. The two cases were treated by closed reduction and percutaneous K-wire fixation and the three cases by open reduction and internal fixation with K-wires. There were 4 cases of complication seldom reported following fracture-separation of the distal humeral epiphysis. This complications consist of 4 dissolutions of trochlea, which is one, frank avascular necrosis of trochlea. In 3 cases with open reduction developed the cubitus varus & dissolution of trochlea. We speculate that this complications results from avascular necrosis of distal end of humerus. Attention to change of carrying angle and radiographic change of distal humeral end are important in detection of complication & evaluation of etiology of dissolution of distal humeral end.

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The Treatment of Comminuted Fractures of Distal Humerus with Rigid Internal Fixation and Early Motion: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Joo Hyung Lee, Seung Jun Park; J Korean Soc Fract 1998;11(1):28-33. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.28

Abstract PDF

Comminuted fractures of distal humerus are difficult fracures to treat because of their rarity and associated significant comminution. The results of managing theses fractures non-operatively are limited by failure to get anantomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudoarthrosis. The goals of open reduction are to preserve articular surface and restore elbow function. Hence an operative management with anatomical reduction of fragments becomes the treatment of choice for these fractures. Authors analyzed 17 patients, with 30 months follow-up on an average, who were treated with open reduction and rigid internal fixation followed early mobilization during the period from jan. 1991 to Dec. 1996. Following results were obtained. 1. According to the Muller's classification, type A was 4 cases(23.5%), type B was 4 (23.5%), and type C was 9(53%) 2. Excellent or good results were obtained in 12 cases(71%) by the criteria of Aitken and Rorabeck. 3. There were limitation of full extension over 5degreein all cases and no other severe complications causing disability of elbow.

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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw
Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee
Journal of the Korean Fracture Society.2007; 20(1): 58. CrossRef

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Supracondylar Closing Wedge Osteotomy for Posttraumatic Angular Deformity of Distal Humerus: Methods for Reducing Secondary Deformity: Sung Soo Kim, Sung Keun Sohn, Chul Hong Kim; J Korean Soc Fract 1996;9(3):706-714. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.706

Abstract PDF: The angular deformity of distal humerus is one of the most frequent complication of supracondylar fracture in growing children. The deformity rarely limits function, but corrected by patients request due to cosmetic problem. Many orthopedic surgeons have suggested various operation methods but with high incidence of complications related to these operations, also we often experience secondary deformity after inaccurate osteotomy. Therefore to identify desirable operative method to reduce secondary deformity, a retrospective study of 17 patients operated with angular deformity following distal humerus fracture was carried out in which replanning with isosceles triangle method was done in all cases. The following results were obtained. 1. The complications were two cases of metal failure and one of non union. 2. The basic requirement of closing wedge osteotomy without secondary deformity was that:the center line of isosceles triangle whose apex angle should be identical to the deformity angle and be placed on the concave apex of deformity, should overlap the transverse bisector of hurnerusforearm axes. In inevitable cases, the disparity should be minimized to alleviate secondary deformity. 3. The translation was calculated by the equation of T=Dxsin Î±(T:translation, D:proximal or distal migration of the point of contact of humerus-forearm axes, Î±:angle of the deformity). In conclusion, we think that the deformity may be corrected safely and easily using minute preoperative planning with application of above principle.

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Treatment for Comminuted fractures of Distal End of Humerus by Newly Developed Anatomical Plate: Three case report: Sung Man Rowe, Eun Sun Moon, Jung Tae Hur; J Korean Soc Fract 1992;5(2):426-432. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.426

Abstract PDF: Comminuted fractures of the distal end of the humerus in adult are notoriously difficult to treat, and had reported many problems. Because anatomical structure around the olecranon fossa was composed by weak trabecular bone, accurate anatomical reduction and rigid fixation of the fracture fragment was not easily achieved by ordinary concept and implants. Recently, various anatomical plates for the fractures of the metaphyseal area of long bone were developed and relatively good results were reported. The authors developed new anatomical plate for distal humerus which had an well adaptable and more malleable characteristics for the fracture of the distal humerus. We report our short experience, of 3 cases treated with this plate.

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Surgical treatment of intercondylar fracture of distal humerus in adult: Chang Ju Lee, Won Ho Cho, Ho Geun Chang, Ju Sung Kim; J Korean Soc Fract 1991;4(1):15-21. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.15

Abstract PDF: No abstract available.

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