Comparison of the curative effects of three fixed methods in the management of distal humeral fractures in adults / 中国基层医药

ABSTRACT

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.