Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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PHILOS Plate Osteosynthesis in Metaphyseal Fractures of the Distal Humerus through an Anterolateral Approach

  • Park, Jung Ho (Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Kim, Jung Wook (Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Oh, Chi Hun (Department of Orthopaedic Surgery, Barun Joint Hospital) ;
  • Choi, Keun Seok (Department of Orthopaedic Surgery, Burteam Hospital) ;
  • Hong, Jae Young (Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Kim, Jae Gyoon (Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine)
  • Received : 2014.10.28
  • Accepted : 2015.03.05
  • Published : 2015.09.30
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Abstract

Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.

Keywords

References

  1. Rose SH, Melton LJ 3rd, Morrey BF, Ilstrup DM, Riggs BL. Epidemiologic features of humeral fractures. Clin Orthop Relat Res. 1982;(168):24-30.
  2. Aitken GK, Rorabeck CH. Distal humeral fractures in the adult. Clin Orthop Relat Res. 1986;(207):191-7.
  3. 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.
  4. Wong AS, Baratz ME. Elbow fractures: distal humerus. J Hand Surg Am. 2009;34(1):176-90. https://doi.org/10.1016/j.jhsa.2008.10.023
  5. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res. 1993; (292):26-36.
  6. Henley MB. Intra-articular distal humeral fractures in adults. Orthop Clin North Am. 1987;18(1):11-23.
  7. 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(3):169-73. https://doi.org/10.1016/0020-1383(95)93495-4
  8. Throckmorton TW, Zarkadas PC, Steinmann SP. Distal humerus fractures. Hand Clin. 2007;23(4):457-69. https://doi.org/10.1016/j.hcl.2007.09.001
  9. Hoppenfeld S, DeBoer P, Buckley R. The humerus. Surgical exposures in orthopaedics: the anatomic approach. 4th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2009. 73-110.
  10. Jupiter JB. Complex non-union of the humeral diaphysis. Treatment with a medial approach, an anterior plate, and a vascularized fibular graft. J Bone Joint Surg Am. 1990;72(5):701-7. https://doi.org/10.2106/00004623-199072050-00009
  11. Thompson JE. Anatomical methods of approach in operations on the long bones of the extremities. Ann Surg. 1918;68(3): 309-29. https://doi.org/10.1097/00000658-191809000-00012
  12. Dabezies EJ, Banta CJ 2nd, Murphy CP, d'Ambrosia RD. Plate fixation of the humeral shaft for acute fractures, with and without radial nerve injuries. J Orthop Trauma. 1992;6(1):10-3. https://doi.org/10.1007/s10195-005-0073-x
  13. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium-2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1-133. https://doi.org/10.1097/00005131-200711101-00001
  14. DiCicco JD, Mehlman CT, Urse JS. Fracture of the shaft of the humerus secondary to muscular violence. J Orthop Trauma. 1993;7(1):90-3. https://doi.org/10.1097/00005131-199302000-00017
  15. Changulani M, Jain UK, Keswani T. Comparison of the use of the humerus intramedullary nail and dynamic compression plate for the management of diaphyseal fractures of the humerus. A randomised controlled study. Int Orthop. 2007; 31(3):391-5. https://doi.org/10.1007/s00264-006-0200-1
  16. Singisetti K, Ambedkar M. Nailing versus plating in humerus shaft fractures: a prospective comparative study. Int Orthop. 2010;34(4):571-6. https://doi.org/10.1007/s00264-009-0813-2
  17. Hollister AM, Saulsbery C, Odom JL, Anissian L, Garon MT, Jordan J. New technique for humerus shaft fracture retrograde intramedullary nailing. Tech Hand Up Extrem Surg. 2011; 15(3):138-43. https://doi.org/10.1097/BTH.0b013e31820246ee

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