Midterm clinical and radiological outcomes of the surgical treatment of complex AO type C distal humeral fractures with two different double plate fixation techniques

Abstract

Introduction: The aim of this retrospective, case series was to report the clinical and radiological outcomes of plate fixation of AO Type C distal humeral fractures and to compare the two techniques, the double plate parallel fixation with the double plate orthogonal fixation.

Case series: Twenty-six consecutive patients had their AO type C distal humeral fracture treated either with the orthogonal (group A: 15 patients; mean age 53.5 years, range 21-96) or the parallel (Group B: 11 patients; mean age 56.5 years, range 17-86) plate fixation. The patients were assessed clinically with the use of Mayo elbow performance index (MEPI), and the grading system of Jupiter as well as radiographically. Twenty four patients (14 from group A and ten from group B) were available for follow-up. The mean follow-up for group A was 48.8 months and for group B, 33 months. According to MEPI, seven elbows were graded as excellent, five as good, one as fair, and one as poor in group A, whereas, in group B, six elbows were graded as excellent, and four as good. According to the Jupiter score, in group A the result was considered excellent in four cases, good in six, fair in three, and poor in one case, while three elbows were graded as excellent and seven as good in group B. Statistical analysis did not reveal any significant differences between the two groups in any of the parameters tested.

Conclusions: Our results provide further evidence that double plate fixation is an adequate treatment option with satisfactory mid-term results for these fractures and indicate that both configurations are equally effective. HIPPOKRATIA 2017, 21(1): 38-42.

Keywords: AO type C; Distal humeral fractures; orthogonal plate technique; parallel plate technique; plate fixation.

Figure 1. Preoperative radiographs (a: frontal view, b: lateral view) of an AO Type C intraarticular distal humeral fracture. Postoperative radiographs (c: frontal view, d: lateral view) after internal fixation with the orthogonal plate technique.

Figure 2. Preoperative radiographs (a: frontal view, b: lateral view) of an AO Type C, intraarticular, distal humeral fracture. Postoperative radiographs (c: frontal view, d: lateral view) after internal fixation with the parallel plate technique.