Precontoured parallel plate fixation of AO/OTA type C distal humerus fractures

Abstract

Objectives: To determine the clinical effectiveness of precontoured parallel plating for the management of Orthopaedic Trauma Association (OTA) type C distal humerus fractures.

Design: Retrospective case series.

Setting: Level I trauma center.

Patients/participants: Between 2001 and 2005, 37 patients with OTA type C distal humerus fractures underwent open reduction and internal fixation exclusively with the Mayo Elbow Congruent Plating system. Thirty-two patients consented to participate in the study.

Intervention: All patients underwent open reduction and internal fixation with a precontoured bicolumn parallel plating system.

Main outcome measurements: Range of motion, Mayo Elbow Performance Score, Disabilities of the Arm, Shoulder and Hand score (DASH), complication rate, and radiographic evaluation.

Results: At a mean of 27 months follow up, the mean arc of elbow flexion-extension motion was 97 degrees (range, 10 degrees -145 degrees ). The mean Mayo Elbow Performance Score was 82 points and the mean DASH score was 24 points. There were no implant failures and all distal humerus fractures healed. A total of 24 complications occurred in 17 patients (53%) with five patients (16%) having postoperative nerve injuries.

Conclusions: Open reduction and internal fixation with a precontoured parallel plating system is an effective treatment method for OTA type C distal humerus fractures. Despite this, the fact that over half of the patients had a significant complication will require utmost vigilance on the part of the surgeon to avoid intraoperative complications. Patient counseling is paramount.