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The functional results of complex distal humeral fractures treated with parallel plate technique

Year 2013, Volume: 19 Issue: 2, 88 - 92, 01.03.2013
https://doi.org/10.5455/GMJ-30-2013-131

Abstract

In our study the functional results of parallel plate technique applied to medial and lateral columns of elbow, in patients with complex elbow fracture were evaluated. Open reduction and internal fixation was performed by using parallel plate technique in 23 patients with complex elbow fracture (14 men, 9 women). Mean age was 39,8 year. The fracture mechanisms were traffic accident in 9 patients, simple fall in 6 patients, fall from high in 8 patients. Mean time from trauma to surgery was 5 days. Functional results were evaluated by using disabilities of the Arm, Shoulder and Hand score (DASH) and Mayo elbow performance score. Range of motion and instability of the elbow joint was also evaluated. Mean follow up was 21 months. Mean flexion/extension arch was 101,8 degree, mean flexion was 125,4 degree, mean extension was 26,3 degree. Mean Mayo elbow performance score was 80,4. Mean DASH score was 11,1. One patient had a nonunion of olecranon osteotomy, one patient had a nonunion at the fracture. Heterotophic ossification was devoloped in 5 patients (21,7%). Surgery was complicated by an infection in 5 patients, and one of them needed debridement due to deep infection. In 3 patients screw and cerclage wires at the osteotomy site were removed due to symptomatic implants. As a result the functional outcomes of the complex elbow fractures that are treated with stabile osteosynthesis which permits early range of motion are satisfactory.

References

  • 1. Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 2003;17(1):38-47.
  • 2. Doornberg JN, van Duijn PJ, Linzel D, Ring DC, Zurakowski D, Marti RK, et al. Surgical treatment of intra-articular fractures of the distal part of the humerus. Functional outcome after twelve to thirty years. J Bone Joint Surg Am 2007;89(7):1524- 32.
  • 3. Eralp L, Kocaoglu M, Sar C, Atalar AC. Surgical treatment of distal intraarticular humeral fractures in adults. Int Orthop 2001;25(1):46-50.
  • 4. Sanchez-Sotelo J, Torchia ME, O’Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. J Bone Joint Surg Am 2007;89(5):961- 9.
  • 5. O’Driscoll SW, Sanchez-Sotelo J, Torchia ME. Management of the smashed distal humerus. Orthop Clin North Am 2002;33(1):19-33.
  • 6. Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 2003;17(1):38-47.
  • 7. Ackerman G, Jupiter JB. Non-union of fractures of the distal end of the humerus. J Bone Joint Surg Am 1988;70(1):75-83.
  • 8. Schemitsch EH, Tencer AF, Henley MB. Biomechanical evaluation of methods of internal fixation of the distal humerus. J Orthop Trauma 1994;8(6):468-75.
  • 9. Self J, Viegas SF, Buford WL Jr, Patterson RM. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg 1995;4(1 Pt 1):10-6.
  • 10. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976;58(4):453-8.
  • 11. Sanchez-Sotelo J, Torchia ME, O’Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. Surgical technique. J Bone Joint Surg Am 2008;90 Suppl 2 Pt 1:31-46.
  • 12. Morrey BF, An KN, Chao EY. Functional evaluation of the elbow. In: Morrey BF, ed. The elbow and its disorders. 2nd ed. Philadelphia: W. B. Saunders; 1993; 86-97.
  • 13. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The upper extremity collaborative group. Am J Ind Med 1996;29(6):602-8.
  • 14. Jupiter JB, Neff U, Holzach P, Allgöwer M. Intercondylar fractures of the humerus. An operative approach. J Bone Joint Surg Am 1985;67(2):226-39.
  • 15. Gabel GT, Hanson G, Bennett JB, Noble PC, Tullos HS. Intraarticular fractures of the distal humerus in the adult. Clin Orthop Relat Res 1987;216:99-108.
  • 16. Özdemir H, Ürgüden M, Söyüncü Y, Aslan T. Long-term functional results of adult intra-articular distal humeral fractures treated by open reduction and plate osteosynthesis. Acta Orthop Traumatol Turc 2002;36(4):328-35.
  • 17. Kınık H, Atalar H, Mergen E. Management of distal humerus fractures in adults. Arch Orthop Trauma Surg 1999;119(7- 8):467-9.
  • 18. Ring D, Jupiter JB. Complex fractures of the distal humerus and their complications. J Shoulder Elbow Surg 1999;8(1):85-97.
  • 19. Ulusal AE, Boz U, Sertöz Z, Ustaoğlu RG. Approaches to distal humeral fractures in adults and comparison of treatment results. Acta Orthop Traumatol Turc 2006;40(1):22-8.
  • 20. Doğramacı Y, Esen E, Kürklü M, Kırıcı Y, Atahan AO, Kömürcü M. Double plate osteosynthesis provides better biomechanical stabilization than double tension band technique
  • 21. Atalar AC, Demirhan M, Salduz A, Kılıçoğlu O, Seyahi A. Functional results of the parallel-plate technique for complex distal humerus fractures. Acta Orthop Traumatol Turc 2009;43(1):21-7.
  • 22. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res 1993;292:26-36.
  • 23. McKee MD, Wilson TL, Winston L, Schemitsch EH, Richards RR. Functional outcome following surgical treatment of intraarticular distal humeral fractures through a posterior approach. J Bone Joint Surg Am 2000;82-A(12):1701-7.

Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları

Year 2013, Volume: 19 Issue: 2, 88 - 92, 01.03.2013
https://doi.org/10.5455/GMJ-30-2013-131

Abstract

Çalışmamızda, kompleks dirsek kırığı nedeniyle başvuran hastalarda, dirsek medial ve lateral kolonlarına uygulanan paralel plaklama tekniğinin fonksiyonel sonuçları değerlendirildi. Kompleks dirsek kırığı nedeniyle başvuran 23 hastaya (14 erkek, 9 kadın) paralel plaklama tekniği ile, açık redüksiyon ve internal tespit uygulandı. Ortalama yaş 39.8 yıl idi. Kırık oluş mekanizması 9 hastada trafik kazası, 6 hastada basit düşme, 8 hastada yüksekten düşme idi. Kırık oluş anı ile ameliyat zamanı arasında geçen süre ortalama 5 gün idi. Dirsek fonksiyonel durumu, Mayo dirsek performans skoru ve kol, omuz ve el engellilik (DASH) skoru ile değerlendirildi. Ayrıca tüm hastalar, eklem hareket açıklıkları ve dirsek instabilitesi açısından değerlendirildi. Ortalama takip süresi 21 aydı. Ortalama fleksiyon/ekstansiyon arkı 101,8 derece, ortalama fleksiyon 125,4 derece, ortalama ekstansiyon 26,3 derece bulundu. Mayo dirsek performans skoru ortalama 80,4 olarak tespit edildi. DASH skoru ortama 11,1 bulundu. Bir hastada olekranon osteotomisinde, bir hastada da kırık bölgesinde kaynama olmadığı görüldü. Beş hastada (%21,7) heterotopik ossifikasyon geliştiği saptandı. Beş hastada operasyon sonrası enfeksiyon bulguları saptandı ve bunlardan bir tanesinde derin enfeksiyon nedeniyle debridman ihtiyacı oldu. Üç hastada olekranon tespit materyallerinin rahatsız etmesi nedeniyle, vida ve serklaj teli çıkarıldı. Sonuç olarak kompleks dirsek kırıklarında erken harekete izin veren stabil bir osteosentez sonrası fonksiyonel sonuçlar tatmin edicidir.

References

  • 1. Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 2003;17(1):38-47.
  • 2. Doornberg JN, van Duijn PJ, Linzel D, Ring DC, Zurakowski D, Marti RK, et al. Surgical treatment of intra-articular fractures of the distal part of the humerus. Functional outcome after twelve to thirty years. J Bone Joint Surg Am 2007;89(7):1524- 32.
  • 3. Eralp L, Kocaoglu M, Sar C, Atalar AC. Surgical treatment of distal intraarticular humeral fractures in adults. Int Orthop 2001;25(1):46-50.
  • 4. Sanchez-Sotelo J, Torchia ME, O’Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. J Bone Joint Surg Am 2007;89(5):961- 9.
  • 5. O’Driscoll SW, Sanchez-Sotelo J, Torchia ME. Management of the smashed distal humerus. Orthop Clin North Am 2002;33(1):19-33.
  • 6. Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma 2003;17(1):38-47.
  • 7. Ackerman G, Jupiter JB. Non-union of fractures of the distal end of the humerus. J Bone Joint Surg Am 1988;70(1):75-83.
  • 8. Schemitsch EH, Tencer AF, Henley MB. Biomechanical evaluation of methods of internal fixation of the distal humerus. J Orthop Trauma 1994;8(6):468-75.
  • 9. Self J, Viegas SF, Buford WL Jr, Patterson RM. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg 1995;4(1 Pt 1):10-6.
  • 10. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976;58(4):453-8.
  • 11. Sanchez-Sotelo J, Torchia ME, O’Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. Surgical technique. J Bone Joint Surg Am 2008;90 Suppl 2 Pt 1:31-46.
  • 12. Morrey BF, An KN, Chao EY. Functional evaluation of the elbow. In: Morrey BF, ed. The elbow and its disorders. 2nd ed. Philadelphia: W. B. Saunders; 1993; 86-97.
  • 13. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The upper extremity collaborative group. Am J Ind Med 1996;29(6):602-8.
  • 14. Jupiter JB, Neff U, Holzach P, Allgöwer M. Intercondylar fractures of the humerus. An operative approach. J Bone Joint Surg Am 1985;67(2):226-39.
  • 15. Gabel GT, Hanson G, Bennett JB, Noble PC, Tullos HS. Intraarticular fractures of the distal humerus in the adult. Clin Orthop Relat Res 1987;216:99-108.
  • 16. Özdemir H, Ürgüden M, Söyüncü Y, Aslan T. Long-term functional results of adult intra-articular distal humeral fractures treated by open reduction and plate osteosynthesis. Acta Orthop Traumatol Turc 2002;36(4):328-35.
  • 17. Kınık H, Atalar H, Mergen E. Management of distal humerus fractures in adults. Arch Orthop Trauma Surg 1999;119(7- 8):467-9.
  • 18. Ring D, Jupiter JB. Complex fractures of the distal humerus and their complications. J Shoulder Elbow Surg 1999;8(1):85-97.
  • 19. Ulusal AE, Boz U, Sertöz Z, Ustaoğlu RG. Approaches to distal humeral fractures in adults and comparison of treatment results. Acta Orthop Traumatol Turc 2006;40(1):22-8.
  • 20. Doğramacı Y, Esen E, Kürklü M, Kırıcı Y, Atahan AO, Kömürcü M. Double plate osteosynthesis provides better biomechanical stabilization than double tension band technique
  • 21. Atalar AC, Demirhan M, Salduz A, Kılıçoğlu O, Seyahi A. Functional results of the parallel-plate technique for complex distal humerus fractures. Acta Orthop Traumatol Turc 2009;43(1):21-7.
  • 22. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res 1993;292:26-36.
  • 23. McKee MD, Wilson TL, Winston L, Schemitsch EH, Richards RR. Functional outcome following surgical treatment of intraarticular distal humeral fractures through a posterior approach. J Bone Joint Surg Am 2000;82-A(12):1701-7.
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ender Alagöz This is me

Oktay Adanır This is me

Serdar Yüksel This is me

Ozan Beytemur This is me

Mehmet Akif Güleç This is me

Kahraman Demiryontar This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 19 Issue: 2

Cite

APA Alagöz, E., Adanır, O., Yüksel, S., Beytemur, O., et al. (2013). Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları. Gaziantep Medical Journal, 19(2), 88-92. https://doi.org/10.5455/GMJ-30-2013-131
AMA Alagöz E, Adanır O, Yüksel S, Beytemur O, Güleç MA, Demiryontar K. Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları. Gaziantep Medical Journal. March 2013;19(2):88-92. doi:10.5455/GMJ-30-2013-131
Chicago Alagöz, Ender, Oktay Adanır, Serdar Yüksel, Ozan Beytemur, Mehmet Akif Güleç, and Kahraman Demiryontar. “Kompleks Humerus Alt Uç kırıklarının Paralel Plaklama tekniği Sonrası Fonksiyonel sonuçları”. Gaziantep Medical Journal 19, no. 2 (March 2013): 88-92. https://doi.org/10.5455/GMJ-30-2013-131.
EndNote Alagöz E, Adanır O, Yüksel S, Beytemur O, Güleç MA, Demiryontar K (March 1, 2013) Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları. Gaziantep Medical Journal 19 2 88–92.
IEEE E. Alagöz, O. Adanır, S. Yüksel, O. Beytemur, M. A. Güleç, and K. Demiryontar, “Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları”, Gaziantep Medical Journal, vol. 19, no. 2, pp. 88–92, 2013, doi: 10.5455/GMJ-30-2013-131.
ISNAD Alagöz, Ender et al. “Kompleks Humerus Alt Uç kırıklarının Paralel Plaklama tekniği Sonrası Fonksiyonel sonuçları”. Gaziantep Medical Journal 19/2 (March 2013), 88-92. https://doi.org/10.5455/GMJ-30-2013-131.
JAMA Alagöz E, Adanır O, Yüksel S, Beytemur O, Güleç MA, Demiryontar K. Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları. Gaziantep Medical Journal. 2013;19:88–92.
MLA Alagöz, Ender et al. “Kompleks Humerus Alt Uç kırıklarının Paralel Plaklama tekniği Sonrası Fonksiyonel sonuçları”. Gaziantep Medical Journal, vol. 19, no. 2, 2013, pp. 88-92, doi:10.5455/GMJ-30-2013-131.
Vancouver Alagöz E, Adanır O, Yüksel S, Beytemur O, Güleç MA, Demiryontar K. Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları. Gaziantep Medical Journal. 2013;19(2):88-92.