Journal of Musculoskeletal Trauma

Treatment of Non-union Distal Humerus Fractures after Operation: Hyung Sik Kim, Ki Joon Jang, Yun Rak Choi, Il Hyun Koh, Ho Jung Kang; J Korean Fract Soc 2012;25(4):310-316. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.310

PURPOSE
This study is a retrospective analysis of patients who had undergone surgical treatment for non-union of distal humerus fracture. We evaluated them in terms of causes of injury, radiologic findings, and clinical outcomes such as prognosis.
MATERIALS AND METHODS
Seven consecutive radiologic patients who were confirmed to have nonunion of a distal humerus fracture underwent reoperations. These patients had already undergone operations for distal humerus fractures. This survey was held from 2005 to 2010. The average period up to diagnosis of non-union after the first operation was 7.4 months (4 to 16 months). The mean follow-up period was 24.6 months (12 to 65 months). Each patient was graded functionally according to the Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand Score.
RESULTS
Osteosynthesis was performed by internal fixation with plates and screws and then a bone graft for non-union of the distal humerus fracture. The average range of motion within the elbow joints was found to be a flexion contracture of 18.8 degrees (0~30 degrees) and further flexion of 120.2 degrees (102~140 degrees). Among postoperative complications, three cases of medium-degree stiffness, two cases of medial column nonunion, and one case of dissociation of the internal fixator were reported.
CONCLUSION
Stable internal fixation for maintenance reduction status is essential after accurate initial anatomical reduction. We concluded that nonunion could be prevented by additional surgical treatment such as autogenous bone graft, if it is necessary.

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Autogenous Inlay Bone Graft for Distal Humerus Nonunion with Metaphyseal Bone Defect: A Technical Note
Yong-Suk Lee, Dongmin Kim, Min-Sung Kang, Jong-Hwa Park, Sang-Uk Lee
Archives of Hand and Microsurgery.2020; 25(1): 39. CrossRef

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Double Parallel Plates Fixation for Distal Humerus Fractures: Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk Jin Lee, Joon Oh Lee, Kyu Won Oh, Hyun Sik Gong; J Korean Fract Soc 2010;23(2):194-200. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.194

Abstract PDF: PURPOSE
The purpose of this study was to review the outcome of fixation of distal humerus fractures using recently-introduced double parallel plate system in sagittal plane.
MATERIALS AND METHODS
From May 2004 to June 2008, seventeen patients with distal humerus fractures underwent primary open reduction and internal fixation with double parallel plates. According to the AO classification, there were 2 A3, 2 C1, 7 C2, and 6 C3 type fractures. Outcome assessment was performed by using the Mayo Elbow Performance index (MEPI).
RESULTS
At a mean follow up of 18 (range, 12 to 32) months, 4 patients were rated as excellent, 8 as good, and 5 as fair in terms of MEPI. The average arc of elbow flexion after primary operation was 116 (range, 90~140) degrees with a mean flexion contracture of 13 (range, 0 to 30) degrees. One patient required reoperation due to fixation failure and six patients underwent capsulolysis and three patients underwent ulnar nerve neurolysis. The time to begin elbow motion exercise had negative correlation with total elbow range of motion and multiple trauma patients had significantly lower MEPI functional score compared to those without combined injury.
CONCLUSION
Double parallel plating allowed adequate fixation for distal humerus fractures regardless of patient age and fracture pattern. Partial ankylosis and unlar nerve compression symptoms were the main causes of reoperation.

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Treatment in Distal Humerus Fracture with Anatomical Y Plate: Eun Sun Moon, Sung Man Rowe, Jong Keun Seon, Myung Sun Kim, Seong Beom Cho; J Korean Fract Soc 2004;17(2):76-82. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.76

Abstract PDF

PURPOSE
To evaluate the clinical results of this modified anatomical Y-plate in treatment of distal humerus fracture and factors that affect the results.
MATERIALS AND METHODS
From April 1991 to January 2002, 40 cases (16 male, 24 female) of distal humeral fractures were treated using a modified anatomical Y plate. The patient's age, gender, pain, range of motion, instability, function, bone union, and complication were recorded.
RESULTS
At the operation, the mean age of patients is 49.5 years (12~74 years) and mean follow up period is 18 months (13~82 months). In the range of motion, mean flexion is 122.1 degrees (75~140 degrees) and mean flexion contracture is 11.4 degrees (0~30 degrees). Results by Morrey's functional evaluation include 15 excellent, 23 good and 2 fair cases. There are 2 excellent and 5 good cases in patients of supracondylar fracture which didn't involve the articular surface (A2, A3 type of AO classification), and 13 excellent, 18 good and 2 fair cases in patients of intracondylar fracture which involve the articular surface (B2, C1, C2, C3 type). But there is no statistical significance in results between two groups. There are 3 excellent, 3 good cases in 6 open fracture and 2 excellent, 6 good and 1 fair case in 9 patients with multiple trauma. The patient's age, gender, open fracture, multiple trauma, and intraarticular fracture did not affect the results.
CONCLUSION
Satisfactory results can be obtained if the modified anatomical Y-plate is used to treat a distal humerus fracture, regardless of many factors affecting the results.

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Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture
Hugo Barret, Romain Ceccarelli, Paul Vial D’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Orthopaedics & Traumatology: Surgery & Research.2023; 109(5): 103380. CrossRef
Étude comparative d’une plaque verrouillée anatomique et innovante en Y par rapport à 2 plaques à 90 degrés pour la prise en charge des fractures supra condyliennes de l’humérus
Hugo Barret, Romain Ceccarelli, Paul Vial d’Allais, Matthias Winter, Michel Chammas, Bertrand Coulet, Cyril Lazerges
Revue de Chirurgie Orthopédique et Traumatologique.2023; 109(5): 648. CrossRef
Double Parallel Plates Fixation for Distal Humerus Fractures
Young Hak Roh, Moon Sang Chung, Goo Hyun Baek, Young Ho Lee, Hyuk-Jin Lee, Joon Oh Lee, Kyu-Won Oh, Hyun Sik Gong
Journal of the Korean Fracture Society.2010; 23(2): 194. CrossRef

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Dual Plate Osteosynthesis for Distal Humeral Fractures: Chang Wu Oh, Hee Soo Kyung, Pook Taek Kim, Il Hyung Park, Yeong Chul Choi; J Korean Soc Fract 2000;13(1):120-125. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.120

Abstract PDF: PURPOSE
: The purpose of this pater was to evaluate results of double plate osteosynthesis in distal humerus fractures. MATERIAL AND METHOD : From June1995 to August 1998, we reviewed 22 distal humerus fractures. According to the type of fractures(AO classification), 6 and 16 cases were type A and C respectively. According to surgical approach, transolecranon approach was done in 12 cases and triceps split approach in 10 cases. We fixed intercondylar fracture with lag screw and supracondylar fracture with dual plate(2 reconstruction plates or 1 reconstruction plate + 1/3 tubular plate) as right angle. Rehabilitation was started just after postoperative 24 hours with posterior splint, and then increase activity and frequency.
RESULTS
: Average union time was 11.5 weeks. Overall functional results according to the classification of Jupiter and Cassebaum were excellent, good, fair, poor in 8, 10, 3, 1 cases, respectively. According to the age, patients under 50-year-old group revealed slightly superior functional. According to the type of fracture, surgical approach, interval between injury and approach, there were no statistically significant difference between group(p>0.05). There were 5 cases with complications. 1 case was mental failure, 3 cases were ulnar palsy, and 1 case was transient radial nerve palsy.
CONCLUSION
: We consider dual plate osteosynthesis in distal humerus fractures as a good treatment modality, even in type C fractures and old age patients.

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Treatment for Comminuted fractures of Distal End of Humerus by Newly Developed Anatomical Plate: Three case report: Sung Man Rowe, Eun Sun Moon, Jung Tae Hur; J Korean Soc Fract 1992;5(2):426-432. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.426

Abstract PDF: Comminuted fractures of the distal end of the humerus in adult are notoriously difficult to treat, and had reported many problems. Because anatomical structure around the olecranon fossa was composed by weak trabecular bone, accurate anatomical reduction and rigid fixation of the fracture fragment was not easily achieved by ordinary concept and implants. Recently, various anatomical plates for the fractures of the metaphyseal area of long bone were developed and relatively good results were reported. The authors developed new anatomical plate for distal humerus which had an well adaptable and more malleable characteristics for the fracture of the distal humerus. We report our short experience, of 3 cases treated with this plate.

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