J Korean Fract Soc.  2016 Jul;29(3):178-184. 10.12671/jkfs.2016.29.3.178.

Orthogonal Locking Compression Plate Fixation for Distal Humeral Intraarticular Fractures

• Oh HK
• Choo SK
• Koh KH
• Yeom JW

• KMID: 2344090
• DOI: http://doi.org/10.12671/jkfs.2016.29.3.178

Abstract

PURPOSE
To investigate the surgical outcomes of orthogonal locking compression plate fixation for distal humeral intraarticular fractures.
MATERIALS AND METHODS
This study included 18 patients presenting a distal humeral intraarticular fracture who were treated with orthogonal locking compression plate fixation. According to the AO/OTA classification, there were eight C2 and ten C3 fractures. We evaluated radiologic outcomes, clinical results with range of motion, operation-related complications, and functional score by Mayo elbow performance score (MEPS).
RESULTS
The a verage u nion t ime was 3.5 months, and there was no c ase of r eduction l oss of a rticular f racture at t he last follow-up. Additional surgical procedures were needed in the three cases of C3 fractures. There was one case of heterotrophic ossification and one case of K-wire irritation. The average range of motion of elbow joint was 7° to 122°, and functional results were graded as 14 excellent, three good, and one fair by MEPS.
CONCLUSION
Anatomical reduction and internal fixation with orthogonal locking compression plate could provide satisfactory surgical outcomes for the treatment of distal humeral intraarticular fracture.

Keyword

Humeral fracture; Intraarticular fracture; Fracture fixation

MeSH Terms

Classification
Elbow
Elbow Joint
Follow-Up Studies
Fracture Fixation
Humans
Humeral Fractures
Intra-Articular Fractures*
Range of Motion, Articular

Figure

• 

  Fig. 1 Plain antero-posterior (AP) X-ray (A) and 3-dimensional computed tomography image (B) of an 84-year-old male show C2 distal humeral intraarticular fracture. Articular fracture was fixed with 4.0 mm partial threaded cancellous screw and orthogonal locking plate fixation was performed without olecranon osteotomy. Last follow-up AP and lateral views (C, D) show solid bony union without implant loosening.

• 

  Fig. 2 (A) A case of comminuted intraarticular distal humeral fracture of a 33-year-old male. Plain X-ray and 3-dimensional computed tomography scans show intraarticular comminuted fracture. (B) Small comminuted articular fragments were fixed with 2.0 mm screws. Orthogonal locking plate fixation was performed and intercondylar fracture was fixed with K-wires and 2.7 mm locking head screw through the lateral plate.

• 

  Fig. 3 (A) A 30-year-old male suffered from open comminuted distal humeral fracture. Open reduction and plate fixation was performed (B), but after range of motion exercise, fixation loss occurred on lateral plate (C). (D) After additional plate fixation, solid bony union could be obtained.

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