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<p><b>OBJECTIVE</b>To compare clinical outcomes of perpendicular or parallel double plate in treating type C fractures of distal humerus in adults.</p><p><b>METHODS</b>From March 2009 and March 2013, 40 adult patients with type C distal humerus fractures were treated. The patients were divided into two groups according to fixed form. In perpendicular group(group A), there were 13 males and 9 females with a mean age of (37.56±9.24) years old(ranged 18 to 56);while in parallel plating group(group B), including 11 males and 7 females, with a mean age of (41.35±9.03) year old(ranged 20 to 53). All fractures were fresh and closed without blood vessels or nerve damaged. Incision length, operating time, blood loss, hospital stay, preoperative and postoperative radiological change, range of activity of elbow joint, Mayo score, flexor and extensor elbow strength, and postoperative complications were observed and compared.</p><p><b>RESULTS</b>All incisions were healed well. One patient occurred myositis ossificans between two groups. Two patients in group A and 1 patient in group B occurred elbow joint stiffness. All fractures were obtained bone union. Group A were followed up from 20 to 36 months with an average of (25.2±7.1) months, while group B were followed up from 18 to 35 months with an average of(24.3±6.0) months. There were significant differences in blood loss and operative time, while there was no obvious meaning in incision length, hospital stay, muscle strength, fracture healing time, range of activity of elbow joint. Mayo score of group A was 82.27±10.43, 6 cases obtained excellent results, 12 good, 3 moderate and 1 poor;in group B was 81.94±12.02, 5 cases obtained excellent results, 9 good, 3 moderate and 1 poor;and there were no statistical significance between two groups.</p><p><b>CONCLUSIONS</b>There was no significant differences in clinical effects between perpendicular and parallel double plate for adult patients with type C distal humerus fractures, while the operation should choose according to facture and proficiency of operator.</p>
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Objective To compare the curative effects of three fixed methods in the management of distal humeral fractures in adults.Methods From January 2012 to December 2015,120 adults patients with distal humeral fractures admitted to our hospital were enrolled in this prospectively study.According to the principle of random digital table,all patients were randomly signed into single plate fixation group,Y type plate fixation group or double plates fixation group.The primary outcomes included surgical approach,elbow function recovery and postoperative complica-tions.Results Significantly differences were observed among the three groups in fracture union time[(99.48 ± 11.81)d vs.(108.93 ±11.05)d vs.(111.35 ±11.11)d,F =12.274,P =0.000)];there was no difference in fracture union time between the single plate fixation group and Y type plate fixation group (t =0.979,P =0.331). However,patients in double plates fixation group got a significantly shorter fracture union time when compared with the single plate fixation group or Y type plate fixation group (t =3.696,4.632,both P =0.000).Significantly differences were observed among the three groups in Mayo elbow performance score three months after the operation[(88.63 ±7.35)points vs.(79.98 ±6.06)points vs.(79.60 ±6.5)points,F =12.274,P =0.000)].There was no difference in Mayo elbow performance score between the single plate fixation group and Y type plate fixation group (t =0.266, P =0.791).However,the patients in the double plates fixation group got a significantly higher Mayo elbow perform-ance score (t =5.742,5.799,both P =0.000).There was no difference among the three groups in operation duration,intraoperative bleeding volume,failure rate of internal fixation,surgical site infection,ulnar neuritis,myositis ossificans and loosening of the plate (all P >0.05).Conclusion Double plates is more in line with the biomechanical characteristics of the distal humerus,and it is beneficial to the functional recovery of elbow joint.
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ObjectiveTo evaluate the effects of double plates in the treatment of humeral intercondylar fractures.MethodsFrom January 2004 to March 2011,31 patients with humeral intercondylarfractures were reviewed.According to AO/Müller classification,there were three patients with type C1 fractures,16 with type C2 and 12 with type C3.Trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of AO double plates were performed in all patients.ResultsAll 31patients were followed up for 12 -18 months,which showed fracture healing 6-12 months after surgery.According to the Cassebaum scoring system,the effects were evaluated as excellent in seven patients,good in 19,fair in four and poor in one,with excellence rate of 87％. ConclusionDouble plates is proved to be a good choice for humeral intercondylar fractures,since it can obtain satisfactory outcome with solid fixation,stable mechanical properties,few complications and facilitation for early rehabilitation.
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PURPOSE: To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures. MATERIALS AND METHODS: Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications. RESULTS: All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication. CONCLUSION: Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.