Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2014 Oct;27(4):294-300. Korean.
    Published online Oct 20, 2014.
    https://doi.org/10.12671/jkfs.2014.27.4.294
    Copyright © 2014 The Korean Fracture Society. All rights reserved.
    Original Article

    A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus

    Tong-Joo Lee, M.D., Ph.D., Young-Tae Kim, M.D., Dae-Gyu Kwon, M.D. and Ju-Yong Park, M.D.
      • Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
    • Address reprint requests to: Tong-Joo Lee, M.D., Ph.D. Department of Orthopedic Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: 82-32-890-3043, Fax: 82-32-890-3047, Email: TJLEE@inha.ac.kr
    Received December 30, 2013; Revised May 19, 2014; Accepted August 10, 2014.

    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

    To analyze the clinical result of a conventional reconstruction plate (CRP) fixation and locking compressive plate (LCP) fixation on the surgical treatment of an adult's displaced intercondylar fracture of humerus.

    Materials and Methods

    A total of 40 patients enrolled in the study were treated between August 2002 and May 2012. Fixation with a CRP was performed in 20 patients (group A) and anatomical locking compression plate fixation was performed in 20 patients (group B). The clinical and functional evaluation was performed according to the Mayo elbow performance score and Cassebaum classification of elbow range of motion (ROM), disabilities of the arm, shoulder and hand score.

    Results

    The Mayo elbow functional evaluation scores, eight cases were excellent, 10 cases were good, and two cases were fair in group A, and 12 cases were excellent, seven cases good, and one case fair in group B; both groups showed satisfactory results. The durations of attaining 90 to 120 degrees of the ROM of joints postoperatively were 8.3 days on average (6 to 15 days) in group A and 5.5 days on average (5 to 9 days) in group B, demonstrating a significant difference between the two groups (p=0.04). Although the correlations of clinical results according to the difference of bone mineral densities (BMDs) were not statistically significant between the two groups (p=0.35), loss of fixation occurred due to loosening of screws in two patients with low BMDs in whose operations reconstruction plates were used.

    Conclusion

    The use of locking compressive plate on the surgical treatment of an diaplaced intercondylar fracture of humerus have a good clinical results because that permits early rehabilitation through good fixation and reduces the complications such as loosening of screws.

    Keywords
    Humeral fracture; Intra-articular fractures; Bone plate; Internal fracture fixation; Osteotomy

    Figures

    Fig. 1
    One case from group A. (A) Initial radiographs show AO/ASIF type C2 fracture of the distal humerus. (B) Postoperative radiographs show a bilateral reconstruction plate through chevron osteotomy of olecranon. (C) At postoperative one year, the patient has excellent range of motion of the elbow from 0° to 150°.

    Fig. 2
    One case from group B. (A) Initial radiographs show AO/ASIF type C2 fracture of the distal humerus. (B) Postoperative radiographs show a bilateral locking compression plate through chevron osteotomy of olecranon. (C) At postoperative one year, the patient has excellent range of motion of the elbow from 0° to 135°.

    Fig. 3
    Follow-up radiographs show screw loosening of the lateral reconstruction plate in a patient with low bone mineral densities in whose operations reconstruction plates were used.

    Tables

    Table 1
    Mayo Elbow Performance Score

    Table 2
    Cassebaums Classification for Elbow Range of Motion

    Table 3
    Other Clinical Results

    Notes

    This study was supported by research fund from Inha University, 2014.

    Conflict of interest: None.

    References

      1. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res 1993;(292):26–36.
      1. Henley MB. Intra-articular distal humeral fractures in adults. Orthop Clin North Am 1987;18:11–23.
      1. Kang CN, Wang JM, Roh KJ, Yun YH, Cho DY. Multiple K Wires fixation of the intercondylar fracture of humerus in adults. J Korean Soc Fract 1993;6:325–330.
      1. Papaioannou N, Babis GC, Kalavritinos J, Pantazopoulos T. Operative treatment of type C intra-articular fractures of the distal humerus: the role of stability achieved at surgery on final outcome. Injury 1995;26:169–173.
      1. Greiner S, Haas NP, Bail HJ. Outcome after open reduction and angular stable internal fixation for supra-intercondylar fractures of the distal humerus: preliminary results with the LCP distal humerus system. Arch Orthop Trauma Surg 2008;128:723–729.
      1. Horne G. Supracondylar fractures of the humerus in adults. J Trauma 1980;20:71–74.
      1. Jupiter JB. Complex fractures of the distal part of the humerus and associated complications. Instr Course Lect 1995;44:187–198.
      1. O'Driscoll SW, Jupiter JB, Cohen MS, Ring D, McKee MD. Difficult elbow fractures: pearls and pitfalls. Instr Course Lect 2003;52:113–134.
      1. Ring D, Gulotta L, Roy A, Jupiter JB. Concomitant nonunion of the distal humerus and olecranon. J South Orthop Assoc 2003;12:27–31.
      1. Ring D, Jupiter JB. Complex fractures of the distal humerus and their complications. J Shoulder Elbow Surg 1999;8:85–97.
      1. Schuster I, Korner J, Arzdorf M, Schwieger K, Diederichs G, Linke B. Mechanical comparison in cadaver specimens of three different 90-degree double-plate osteosyntheses for simulated C2-type distal humerus fractures with varying bone densities. J Orthop Trauma 2008;22:113–120.
      1. Aitken GK, Rorabeck CH. Distal humeral fractures in the adult. Clin Orthop Relat Res 1986;(207):191–197.
      1. 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.
      1. Shin R, Ring D. The ulnar nerve in elbow trauma. J Bone Joint Surg Am 2007;89:1108–1116.
      1. Wang KC, Shih HN, Hsu KY, Shih CH. Intercondylar fractures of the distal humerus: routine anterior subcutaneous transposition of the ulnar nerve in a posterior operative approach. J Trauma 1994;36:770–773.
    MeSH Terms
    Arm
    Bone Density
    Bone Plates
    Classification
    Elbow
    Fracture Fixation, Internal
    Hand
    Humans
    Humeral Fractures
    Humerus*
    Intra-Articular Fractures
    Joints
    Osteotomy
    Range of Motion, Articular
    Rehabilitation
    Retrospective Studies*
    Shoulder
    Metrics
    Share
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    Tables
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    Funding Information
    PERMALINK