Technical tip: fixation of extra-articular fractures of distal humerus with modified distal tibial locking plate
Abstract
Introduction- Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa.
Objectives- This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture.
Methods- By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa.Fourteen cases treated in such manner were followed up for a minimum of 24 months.
Results- Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection.
Conclusion- Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures
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References
2. Jawa A, McCarty P, Doornberg J, Harris M, Ring D. Extra-articular distal-third diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am. 2006 ;88(11):2343-7. DOI:10.2106/JBJS.F.00334
3. Jain D, Goyal GS, Garg R, Mahindra P, Yamin M, Selhi HS. Outcome of anatomic locking plate in extraarticular distal humeral shaft fractures. Indian J Orthop. 2017;51(1):86-92. DOI: 10.4103/0019-5413.197554.
4. Morrey BF. The elbow and its disorders. Elsevier Health Sciences; 2009.
5. McKee MD. Fractures of the shaft of the humerus. In Rockwood and Green’s Fractures in Adults,Bucholz RW, Heckman JD, Court-Brown CM, Editors. 2006, Lippincott Williams & Wilkins: Philadelphia. p. 1117-1159
6. Aitken GK, Rorabeck CH. Distal humeral fractures in the adult. Clin Orthop Relat Res. 1986 ;(207):191-7.
7. Schatzker J, Tile M, Axelrod TS. The rationale of operative fracture care. Berlin: Springer; 2005.
8. Sarmiento A, Waddell JP, Latta LL. Diaphyseal humeral fractures: treatment options. Instr Course Lect. 2002;51:257- 69.
9. Moran MC. Modified lateral approach to the distal humerus for internal fixation. Clin Orthop Relat Res. 1997;(340):190-7.
DOI:10.1097/00003086-199707000-0002
10. Levy JC, Kalandiak SP, Hutson JJ, Zych G. An alternative method of osteosynthesis for distal humeral shaft fractures. J Orthop Trauma. 2005;19(1):43-7.
11. Scolaro JA, Voleti P, Makani A, Namdari S, Mirza A, Mehta S. Surgical fixation of extra-articular distal humerus fractures with a posterolateral plate through a triceps-reflecting technique. J of Should Elbow Surg. 2014 ;23(2):251-7. DOI: 10.1016/j.jse.2013.09.020.
12. Radulescu R, Badila A, Nutiu O, Japie I, Terinte S, Radulescu D, Manolescu R. Osteosynthesis in fractures of the distal third of humeral diaphysis. Maedica. 2014;9(1):44.
13. Brug E, Winckler S, Klein W. Distal diaphyseal fractures of the humerus. Unfallchirurg.1994; 97:72–74
14. Kharbanda Y, Tanwar YS, Srivastava V, Birla V, Rajput A, Pandit R. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach. 2017;12(1):1-9.DOI:10.1007/s11751-016-0270-6
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