Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2013 Oct;26(4):254-260. Korean.
    Published online Oct 18, 2013.
    https://doi.org/10.12671/jkfs.2013.26.4.254
    Copyright © 2013 The Korean Fracture Society. All rights reserved.
    Original Article

    Posterior-Posterior Dual Plates Fixation for the Distal Humerus Fractures

    Yoon-Min Lee, M.D., Seok-Whan Song, M.D., Ph.D., Ki-Bum Choi, M.D., Yoo-Joon Sur, M.D., Ph.D.,* and Sung-Eun Kim, M.D.
      • Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
      • *Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Korea.
    • Address reprint requests to: Seok-Whan Song, M.D., Ph.D. Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine, 222 Banpodaero, Seocho-gu, Seoul 137-701, Korea. Tel: 82-2-3779-1192, Fax: 82-2-783-0252, Email: sw.song@catholic.ac.kr
    Received December 09, 2012; Revised February 21, 2013; Accepted July 14, 2013.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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.

    Keywords
    Distal humerus; Fracture; Posterior-posterior plate fixation

    Figures

    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

    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.

    Tables

    Table 1
    Summary of Cases

    References

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