Universität zu Köln

Hackl, Michael ORCID: 0000-0002-6183-5621, Lanzerath, Fabian, Ries, Christian, Harbrecht, Andreas, Leschinger, Tim, Wegmann, Kilian and Mueller, Lars Peter (2023). Trans-fracture approach for ORIF of coronal shear fractures of the distal humerus. Arch. Orthop. Trauma Surg., 143 (5). S. 2519 - 2528. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Introduction Open reduction and internal fixation (ORIF) of comminuted coronal shear fractures of the distal humerus is challenging. When a concomitant lateral condyle fracture is present, it may be used for a trans-fracture approach to facilitate exposure and fracture reduction. This study aimed to investigate the frequency of lateral condyle fractures in coronal shear fractures of the distal humerus and analyze fracture reduction, fracture union and clinical results following ORIF through a trans-fracture approach. Materials and methods All adult patients who underwent treatment for an acute distal humerus fracture during a three-year period in our level-one trauma center were identified. All fractures were classified according to the Orthopaedic Trauma Association (OTA/AO) fracture classification system and all B3 fractures were classified according to the Dubberley classification. B3 fractures with a concomitant radial condyle fracture were identified. The clinical and radiological results, (Mayo Elbow Performance Score = MEPS, Visual Analogue Scale = VAS, range of motion), complications and revision surgeries were analyzed. Results 53 patients (mean age 52 +/- 19 years) were identified. 13 fractures (24.5%) were B3 fractures. Four of them (30.8%) had a concomitant radial condyle fracture. All of these patients underwent ORIF with headless cannulated compression screws and a (postero-)lateral locking plate through a trans-fracture approach. At a minimum follow-up of 24 months, the MEPS was 88 +/- 12 points, the VAS was 2 +/- 1 and the range of motion was 118 degrees +/- 12 degrees. All fractures showed anatomic reduction. One patient developed partial avascular necrosis and underwent arthrolysis at 6 months. One patient underwent partial hardware removal and lateral collateral ligament bracing at 6 months. Conclusions Lateral condyle fractures are present in about one third of coronal shear fractures of the distal humerus. This injury can be used for a trans-fracture approach to facilitate exposure and to reliably achieve anatomic fracture reduction.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Lanzerath, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ries, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbrecht, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-673301
DOI:	10.1007/s00402-022-04501-6
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	143
Number:	5
Page Range:	S. 2519 - 2528
Date:	2023
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPEN REDUCTION; INTERNAL-FIXATION; CLOSED REDUCTION; CAPITELLAR; ELBOW Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67330