Sharaby Mohamed, Elhawary Ahmed
Mansoura University Emergency Hospital, Mansoura, Egypt.
Acta Orthop Belg. 2012 Dec;78(6):708-13.
Plate fixation of extraarticular distal humeral shaft fracture is often difficult. Traditional techniques do not allow for stable fixation. A single DCP plate may have inadequate purchase in the distal fragment. The use of large plates extending distally over the lateral supracondylar ridge is often associated with pain and sometimes interferes with elbow range of motion. In this study, 22 patients with extra articular distal humeral fractures were managed with dual plating using a paratricipital approach. The first plate--a narrow DCP--was fixed on the dorsal surface of the humerus. The second plate--a small 3.5 reconstruction plate--was fixed on the dorsolateral surface. Elbow motion was started immediately after surgery. The average follow-up duration was 25 months. The mean elbow flexion/extension are was 4 degrees to 138 degrees. Infection was reported in two cases and was managed successfully with conservative measures. Postoperative radial nerve contusion was reported in one case with complete resolution within 3 months.
肱骨远端关节外骨干骨折的钢板固定通常很困难。传统技术无法实现稳定固定。单个动力加压钢板(DCP)可能对远侧骨折块的把持力不足。使用向远侧延伸至肱骨外侧髁上嵴的大钢板常伴有疼痛,有时还会影响肘关节活动范围。在本研究中,22例肱骨远端关节外骨折患者采用经三头肌旁入路双钢板固定治疗。第一块钢板——一块窄DCP——固定于肱骨背侧。第二块钢板——一块小型3.5重建钢板——固定于背外侧表面。术后立即开始肘关节活动。平均随访时间为25个月。平均肘关节屈伸弧度为4度至138度。报告2例感染,经保守治疗成功处理。报告1例术后桡神经挫伤,3个月内完全恢复。