FUNCTIONAL OUTCOME OF EXTRA-ARTICULAR DISTAL HUMERUS FRACTURE FIXATION USING A LATERAL COLUMN LOCKING COMPRESSION PLATE

Authors

  • Araib Ghega Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore
  • Farzad Effan Pathology Department, Lahore Medical & Dental College, Lahore
  • Hizbullah Riaz Ansari Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore
  • Mohammad Tallal Abdullah Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore
  • Shahzad Javaid Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore
  • Amer Aziz Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

DOI:

https://doi.org/10.55519/JAMC-03-S1-10288

Keywords:

Humeral fractures, orthopedic fixation devices, internal fixators, radial neuropathy

Abstract

Background: A host of different methodologies have been implemented in the management of distal humerus fractures, including conservative measures and surgical fixation with a variety of plates. This study was conducted to evaluate the functional outcome of open reduction and internal fixation of extra articular distal humerus fractures with distal humerus locking compression plate. Methods: This is a retrospective cohort study of patients with close extra articular distal humerus fractures who underwent open reduction and internal fixation with a distal humerus locking compression plate at Ghurki Trust Teaching Hospital from July 2017 to December 2019. Various demographic indicators were used for data analysis and radiological union was assessed in serial follow-ups. Functional outcome was evaluated using the Mayo Performance Elbow Score at the final follow-up. Results: Thirty-one patients presented with extra-articular fracture of humerus (N=31) with average age 33.5±9.90 years. The average follow-up period was 13.8 months. Radiological union was achieved in 14.8 weeks (range 12–20 weeks). Out of 31 patients, 28 had excellent results with mean Mayo Elbow Performance Score of 94.8. Two patients (6.5%) had radial nerve palsy post-operatively. Conclusion: This study shows that open reduction and internal fixation of extra-articular distal humerus fractures with distal humerus locking compression plates allows for stable fixation, good functional outcome, and low complication rates.

Author Biographies

Araib Ghega, Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

Post-graduate resident in Department of Orthopedics and Spine Surgery at Ghurki Trust Teaching Hospital, Lahore

Farzad Effan, Pathology Department, Lahore Medical & Dental College, Lahore

Demonstrator in Pathology Department of Lahore Medical & Dental College, Lahore

Hizbullah Riaz Ansari, Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

Post-graduate Resident in Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore.

Mohammad Tallal Abdullah, Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

Post-graduate Resident in Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore.

Shahzad Javaid, Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

Professor at Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore.

Amer Aziz, Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore

Professor and Head of Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore.

References

Trikha V, Agrawal P, Das S, Gaba S, Kumar A. Functional outcome of extra-articular distal humerus fracture fixation using a single locking plate: A retrospective study. J Orthop Surg (Hong Kong) 2017;25(3):2309499017727948.

Tejwani NC, Murthy A, Park J, McLaurin TM, Egol KA, Kummer FJ. Fixation of extra-articular distal humerus fractures using one locking plate versus two reconstruction plates: a laboratory study. J Trauma 2009;66(3):795–9.

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. Strategies Trauma Limb Reconstr 2017;12(1):1–9.

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.

Ali N, Ahmad Mir N, Ahmad Dar T, Nawaz Rather M, Ahmad Mir W, S S, et al. Outcome of Extra-Articular Distal Humerus Fractures Fixed by Single Column Extra-Articular Distal Humerus Locking Compression Plate Using Triceps Sparing Postero-Lateral Approach. Bull Emerg Trauma 2018;6(4):306–2.

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.

Ayoub MS, Tarkin IS. Best care paradigm to optimize functionality after extra-articular distal humeral fractures in the young patient. J Clin Orthop Trauma 2018;9(Suppl 1):S116–22.

Dutta A, Kotoky AJ, Sipani AK, Daolagupu AK. Clinical study on the management of extra-articular distal humerus fracture treated with extra-articular distal humeral locking compression plate. Int J Orthop 2019;5(1):1–6.

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.

Ring D, Jawa A, Cannada L. Clinical Faceoff: Are Distal-third Diaphyseal Humerus Fractures Best Treated Nonoperatively? Clin Orthop Relat Res 2016;474(2):310–4.

Zimmerman MC, Waite AM, Deehan M, Tovey J, Oppenheim W. A biomechanical analysis of four humeral fracture fixation systems. J Orthop Trauma 1994;8(3):233–9.

Moran MC. Modified lateral approach to the distal humerus for internal fixation. Clin Orthop Relat Res 1997;(340):190–7.

Spitzer AB, Davidovitch RI, Egol KA. Use of a "hybrid" locking plate for complex metaphyseal fractures and nonunions about the humerus. Injury. 2009;40(3):240–4.

Saragaglia D, Rouchy RC, Mercier N. Fractures of the distal humerus operated on using the Lambda® plate: report of 75 cases at 9.5 years follow-up. Orthop Traumatol Surg Res 2013;99(6):707–12.

El Mahboub N, Arafat W. Open reduction and internal fixation of extra-articular comminuted distal humerus fractures by double-plating osteosynthesis. Egypt Orthop J 2012;47(4):393–8.

Gösling T, Schandelmaier P, Marti A, Hufner T, Partenheimer A, Krettek C. Less invasive stabilization of complex tibial plateau fractures: a biomechanical evaluation of a unilateral locked screw plate and double plating. J Orthop Trauma 2004;18(8):546–51.

Yang Q, Wang F, Wang Q, Gao W, Huang J, Wu X, et al. Surgical treatment of adult extra-articular distal humeral diaphyseal fractures using an oblique metaphyseal locking compression plate via a posterior approach. Med Princ Pract 2012;21(1):40–5.

Jain D A, Rahul P, Conrad A, Franco. Treatment of distal humerus extra-articular fractures using a single 3.5mm precontoured locking compression plate. J Kar Orth Assoc 2018;6(2):7–11.

Scolaro JA, Hsu JE, Svach DJ, Mehta S. Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants. Injury 2014;45(12):2040–4.

Fawi H, Lewis J, Rao P, Parfitt D, Mohanty K, Ghandour A. Distal third humeri fractures treated using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate: clinical, radiographic and patient outcome scores. Shoulder Elbow 2015;7(2):104–9.

Capo JT, Debkowska MP, Liporace F, Beutel BG, Melamed E. Outcomes of distal humerus diaphyseal injuries fixed with a single-column anatomic plate. Int Orthop 2014;38(5):1037–43.

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Published

2022-06-24