J Korean Fract Soc.  2013 Oct;26(4):254-260. 10.12671/jkfs.2013.26.4.254.

Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures

• Lee YM
• Song SW
• Choi KB
• Sur YJ
• Kim SE

• KMID: 2183825
• DOI: http://doi.org/10.12671/jkfs.2013.26.4.254

Abstract

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.

Keyword

Distal humerus; Fracture; Posterior-posterior plate fixation

MeSH Terms

Elbow Joint
Follow-Up Studies
Humans
Humerus*
Pronation
Range of Motion, Articular
Supination
Ulnar Nerve

Figure

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  Fig. 1 (A) Initial radiographs show a distal humerus fracture with comminution (AO classification C2). (B) Fracture site was well reduced and fixed with posterior-posterior dual plates. (C) Last follow-up radiographs

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  Fig. 2 (A) Initial radiographs show fixation failure with anterior angulation and nonunion of the fracture site. (B) At postoperation 12 weeks, union was achieved at the nonunion site.

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