Journal of Musculoskeletal Trauma

Distal Humerus Fracture: How to Choose the Approach, Implant, Fixation and Rehabilitation: Min Ho Lee, Young Ho Lee; J Korean Fract Soc 2019;32(1):72-81. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.72

Abstract PDF: Distal humerus fractures require stable fixation and early joint motion, similar to other intra-articular fractures, but are difficult to treat adequately because of the anatomical complexity, severe comminution, and accompanying osteoporosis. In most cases, surgical treatment is performed using two supporting plates. Plate fixation can be divided into right angle plate fixation and parallel plate fixation. In addition, depending on the type of fracture, surgical procedures can be performed differently, and autologous bone grafting can be required in the case of severe bone loss. The elbow joint is vulnerable to stiffness, so it is important to start joint movement early after surgery. Postoperative complications, such as nonunion, ulnar nerve compression, and heterotopic ossification, can occur. Therefore, accurate and rigid fixation and meticulous manipulation of soft tissues are required during surgery.

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Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus: Dae Gyu Kwon, Kyoung Ho Moon, Suk In Na, Byung Ki Shin, Tong Joo Lee; J Korean Fract Soc 2012;25(3):185-190. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.185

PURPOSE
The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve.
MATERIALS AND METHODS
We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function.
RESULTS
Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications.
CONCLUSION
The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.

Citations

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Posterior Dual Plating for Distal Shaft Fractures of the Humerus
Chul-Hyun Cho, Kwang-Yeung Jeong, Beom-Soo Kim
Journal of the Korean Fracture Society.2017; 30(3): 117. CrossRef
Modified Combined Approach for Distal Humerus Shaft Fracture: Anterolateral and Lateral Bimodal Approach
Tong Joo Lee, Dae Gyu Kwon, Suk In Na, Seung Do Cha
Clinics in Orthopedic Surgery.2013; 5(3): 209. CrossRef

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Ipsilateral Distal Radius and Scaphoid Fractures Associated with Posteromedial Dislocation of the Elbow Joint: A Case Report: Jin Wan Kim, Young Chul Ko, Chul Young Jung, Il Soo Eun, Young Jun Kim, Chang Kyu Kim; J Korean Fract Soc 2012;25(2):150-154. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.150

Abstract PDF: Arm injuries occurring from high energy injuries such as falls or traffic accidents can be accompanied by wrist and elbow injuries. Monteggia fracture, Galeazzi fracture, and Essex-Lopresti fracture-dislocation are known some examples of such injuries. However, there are no reports on the dislocation of the elbow occurring from a distal radius fracture accompanied by scaphoid fracture, and there is nothing published about its prognosis. The authors report on the treatment and outcomes of a case of a 42-year-old male who had a distal radius and scaphoid fracture associated with posteromedial dislocation of the elbow on the same side of his arm along with a literature review.

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A Clinical Study of the Intra-articular Fracture of the Elbow Joint Fixed with Herbert Sciew: Won Sik Choy, Hyun Dae Shin, Whan Jeung Kim, Kwang Won Lee, Hyun Jong Park, Yoo In Kim; J Korean Soc Fract 1996;9(4):1111-1117. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1111

Abstract PDF: The intra-anicular fracture of the elbow joint can render the elbow joint unstable. In this situation. it is desired to reduce and fix the bone fragment internally. The goal of treatment of the intra-aficular fracture of the elbow joint is a painless, stable elbow to provide a favorable range of motion. Fourteen patients of the intra-articular fraciure of the elbow joint who were treated with Herbert screw in Eul Ji General Hospital, Taejon from October, 1993 to December, 1994. were analyzed in clinical and radiologic aspects. The results obiained from this study were as follows; 1. Among 74 patients, male were 11 cases(78.5%) and female were 3 cases(21.5%). 2. The average age of patients were 31.8 years with range from 15 years to 11 years and the follow-up period ranged from 16 months to 33 months with average 19.6 months. 3. The most common cause of injury was fall down(50.0%) followed by slip down(28.5%) and traffic acrident(21.5%). 4. The most common intra-articular frarture of the elbow joint was capitellum fracture(50.0%) rollowed by radial head fracture(35.6%). 5. Through late radiologic assessment, there was 1 case of post-traumatic arthritis. 6. The result of treatment were excellent in 6 patients(42.8%), good in 1 patients(50.0%) fair in 1 patient(7.2%) by functional rating index of Morrey.

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