Double-locking Precontoured Plating System for Malunited Fractures of the Distal End of Humerus

Overview

Journal Musculoskelet Surg

Date 2016 Dec 1

PMID 27900709

Citations 1

Authors

L Tarallo

R Mugnai

M Rocchi

C Rovesta

F Catani

Affiliations

Soon will be listed here.

Abstract

Background: Distal humeral malunions are uncommon injuries, often associated with limited elbow motion, pain, instability, weakness, and sometimes ulnar neuritis. The complex anatomy of the elbow joint makes this condition one of the most complex elbow injuries to treat.

Materials And Methods: Four patients were treated by the same surgeon between 2011 and 2013 using a double-locking precontoured plating system for malunited intra-articular or extra-articular fractures of the distal end of the humerus.

Results: At a mean 3 years of follow-up, a significant improvement in the elbow motion and functional outcome, evaluated with the Mayo Elbow Performance Index and the Disability of the Arm, Shoulder, and Hand, were observed. Articular reduction obtained after the surgery was maintained in all patients without evidence of avascular necrosis. No other complications (i.e., infection, nervous iatrogenic lesions) were reported.

Conclusions: Corrective osteotomy using double-locking precontoured plating system preceded by preoperative planning using a CT scan allowed an improvement in the functional outcome and elbow motion, without complications.

Citing Articles

Modified pin and plate fixation for low intercondylar fractures of the humerus: biomechanical study corroborated with a case series.

Jitprapaikulsarn S, Chantarapanich N, Gromprasit A, Mahaisavariya C, Patamamongkonchai C Musculoskelet Surg. 2022; 107(2):207-221.

PMID: 35362865 DOI: 10.1007/s12306-022-00743-0.

References

Tarallo L, Mugnai R, Adani R, Catani F . Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate. J Orthop Traumatol. 2014; 15(4):285-90. PMC: 4244554. DOI: 10.1007/s10195-014-0307-x. View

Court-Brown C, Cattermole H, McQueen M . Impacted valgus fractures (B1.1) of the proximal humerus. The results of non-operative treatment. J Bone Joint Surg Br. 2002; 84(4):504-8. DOI: 10.1302/0301-620x.84b4.12488. View

McKee M, Jupiter J, Toh C, Wilson L, Colton C, Karras K . Reconstruction after malunion and nonunion of intra-articular fractures of the distal humerus. Methods and results in 13 adults. J Bone Joint Surg Br. 1994; 76(4):614-21. View

Jupiter J, Mehne D . Fractures of the distal humerus. Orthopedics. 1992; 15(7):825-33. DOI: 10.3928/0147-7447-19920701-07. View

Ducrot G, Bonnomet F, Adam P, Ehlinger M . Treatment of distal humerus fractures with LCP DHP™ locking plates in patients older than 65 years. Orthop Traumatol Surg Res. 2013; 99(2):145-54. DOI: 10.1016/j.otsr.2012.12.011. View

Cohen M, Jupiter J . Intra-articular osteotomy for malunited articular fractures of the distal end of the humerus. J Shoulder Elbow Surg. 2014; 23(4):579-85. DOI: 10.1016/j.jse.2013.12.020. View

ODriscoll S, Spinner R, McKee M, Kibler W, Hastings 2nd H, Morrey B . Tardy posterolateral rotatory instability of the elbow due to cubitus varus. J Bone Joint Surg Am. 2001; 83(9):1358-69. DOI: 10.2106/00004623-200109000-00011. View

Ring D, Jupiter J . Fractures of the distal humerus. Orthop Clin North Am. 2000; 31(1):103-13. DOI: 10.1016/s0030-5898(05)70131-0. View

Sanders R, Sackett J . Open reduction and internal fixation of delayed union and nonunion of the distal humerus. J Orthop Trauma. 1990; 4(3):254-9. DOI: 10.1097/00005131-199004030-00003. View

10.

Morrey B, Bryan R, Dobyns J, Linscheid R . Total elbow arthroplasty. A five-year experience at the Mayo Clinic. J Bone Joint Surg Am. 1981; 63(7):1050-63. View

11.

Court-Brown C, Garg A, McQueen M . The translated two-part fracture of the proximal humerus. Epidemiology and outcome in the older patient. J Bone Joint Surg Br. 2001; 83(6):799-804. DOI: 10.1302/0301-620x.83b6.11401. View

12.

Hudak P, Amadio P, Bombardier C . Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996; 29(6):602-8. DOI: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L. View

13.

RISEBOROUGH E, Radin E . Intercondylar T fractures of the humerus in the adult. A comparison of operative and non-operative treatment in twenty-nine cases. J Bone Joint Surg Am. 1969; 51(1):130-41. View

14.

Tarallo L, Mugnai R, Adani R, Zambianchi F, Costanzini C, Catani F . Shear fractures of the distal humerus: Is the use of intra-articular screws a safe treatment?. Musculoskelet Surg. 2015; 99(3):217-23. DOI: 10.1007/s12306-015-0386-8. View

15.

Ring D, Gulotta L, Chin K, Jupiter J . Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. J Orthop Trauma. 2004; 18(7):446-9. DOI: 10.1097/00005131-200408000-00010. View