An alternative osteosynthesis technique: single column anatomical plate fixation for distal humerus diaphyseal fractures

Authors

  • Benjamin Vinodh J. Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Naveen Sathiyaseelan Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Vignesh Gajendran Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Arun Vignesh Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India
  • Nitesh Kumar Rathi Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20233267

Keywords:

Humerus, Diaphyseal fractures, MEPS score, Anatomical locking compression plate, Gustilo Anderson classification

Abstract

Background: The treatment of distal humerus diaphyseal fractures presents significant challenges for orthopedic surgeons. The goal of this study is to evaluate the effectiveness and outcomes of a single column anatomical plate as an alternative method of osteosynthesis for fixing distal humerus diaphyseal fractures.

Methods: A Prospective analysis of patients who underwent surgery for distal humerus diaphyseal fractures at a tertiary care medical center was conducted. Patients who received treatment using a single column anatomical plate were included in the study. Preoperative, intraoperative, and postoperative data, including fracture type, surgical approach, complications, range of motion, and radiographic outcomes, were collected and analyzed.

Results: Type B2 fractures were more common in our study i.e., 80%. The maximum incidence was between 18 to 59 years i.e., 21 cases (77%). Average radiological union was seen at 15 weeks. This study shows Excellent outcome in 67% and Good in 30% of patients. Average post-operative ROM at 1 year was mean flexion 120°(SD 7), mean extension of 6 degrees (SD 4.7), mean pronation 81.25°(SD 2.5) and mean supination 82.5°(2.8). Average MEPS score was 95.5 at 1 year. The mean metaphyseal-diaphyseal angle was 85°, the mean humeral-ulnar angle was 14°, which was within the normal limits.

Conclusion: The use of a single column anatomical plate for fixing distal humerus diaphyseal fractures appears to be a promising alternative method of osteosynthesis. However, further prospective studies with larger sample sizes and longer follow-up periods are warranted to validate the efficacy and safety of this technique.

References

Ekholm R, Adami J, Tidermark J, Hansson K, Törnkvist H, Ponzer S. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br. 2006;88(11):1469-73.

Self J, Viegas SF, Buford WL Jr, Patterson RM. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg. 1995;4(1):10-6.

Waddell JP, Hatch J, Richards R. Supracondylar fractures of the humerus–results of surgical treatment. J Trauma. 1988;28(12):1615-21.

Stewart MJ, Hundley JM, Tennessee M. Fractures of the humerus-A comparative study in methods of treatment. J Bone Joint Surg Am. 1955;37:11.

Sarmiento A, Horowitch A. Functional bracing for comminuted extra-articular fractures of the distal third of the humerus. J Bone Joint Surg Br. 1990;72(2):283-7.

Ring D, Harris M, Doornberg J, McCarty P, Jawa A. Extra-articular distal-third diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am. 2006;88:2343-7.

Kumar MN, Ravishankar MR, Manur R. Single locking compression plate fixation of extra-articular distal humeral fractures. J Orthopaed Traumatol. 2015; 16:99-104.

Ozcan P. Functional treatment of the distal third humeral shaft fractures. Arch Orthopaed Trauma Surg. 2002;122:390-5.

Levy JC, Kalandiak SP, Hutson JJ, Zych G. An alternative method of osteosynthesis for distal humeral shaft fractures. J Orthop Trauma. 2005;19:43-7.

Spitzer AB, Davidovitch RI, Egol KA. Use of a ‘‘hybrid’’ locking plate for complex metaphyseal fractures and non unions about the humerus. Injury. 2009;40:240-4.

Kumar MN, Manu R. Single locking compression plate fixation of extra-articular distal humeral fractures. Arch Orthopaed Trauma Surg. 2012;182:23-9.

Rajendraprasad B, Karn VV, Padmawar S. Evaluation of extra-articular distal humerus diaphyseal fractures treated with single pre-contoured locking lateral column plating. J Bone Joint Surg Br. 1993;64(1):123-8.

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Published

2023-10-26

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Original Research Articles