Aggarwal Sameer, Kumar Vishal, Bhagwat Kishan R, Behera Prateek
Department of Orthopaedic Surgery, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Eur J Orthop Surg Traumatol. 2014 May;24(4):505-11. doi: 10.1007/s00590-013-1217-y. Epub 2013 Apr 7.
LCP extra-articular plate designed by AO has been used in extra-articular fractures of the distal humerus, mal-unions, and nonunions of the distal humerus. They provide anatomically shaped and angular stable fixation system for extra-articular fractures of the distal humerus. We extended the usage spectrum of this plate to the extra-articular with intra-articular distal humerus fractures and compared it with the standard orthogonal locking plate fixation.
We included 22 consecutive distal humerus intra-articular fractures with metaphyseal and diaphyseal extension into the study. Each case underwent osteosynthesis with LCP extra-articular plate fixation and augmented the intra-articular fragments with 4.0 mm partially threaded cancellous screws. The cost, surgical time, VAS, Modified Mayo Clinic Performance Index for elbow, and postoperative complications were recorded. The radiological union and postoperative elbow range of motion were assessed at 6 weeks, 6, and 12 months of follow-up. Twenty cases completed the scheduled follow-up. The results were compared with retrospective data of 20 cases from our institute where similar fractures were treated with standard orthogonal LCP distal humerus plate (LCPDHP).
The radiological union rates and the range of motion at 6 weeks, 6, and 12 months in both the groups were comparable and did not vary significantly (p > 0.05). The cost and operative time with the LCP extra-articular plates were significantly less (p < 0.05) when compared to the group LCPDHP.
The usage spectrum of extra-articular distal humerus locking plate can be extended to intra-articular fractures. It provides good results and significantly reduces the cost and operative time.
AO设计的锁定加压接骨板(LCP)已用于肱骨远端关节外骨折、畸形愈合及不愈合。它们为肱骨远端关节外骨折提供了符合解剖形状且角度稳定的固定系统。我们将此钢板的应用范围扩展至肱骨远端关节内合并关节外骨折,并与标准正交锁定钢板固定进行比较。
我们纳入了22例连续的肱骨远端关节内骨折且骨折延伸至干骺端和骨干的病例进行研究。每例均采用LCP关节外钢板固定进行骨接合术,并用4.0 mm部分螺纹的松质骨螺钉增强关节内骨折块的固定。记录费用、手术时间、视觉模拟评分(VAS)、改良的梅奥诊所肘关节功能指数以及术后并发症。在随访的6周、6个月和12个月时评估影像学愈合情况及术后肘关节活动范围。20例完成了预定的随访。将结果与本机构20例采用标准正交肱骨远端锁定加压接骨板(LCPDHP)治疗类似骨折的回顾性数据进行比较。
两组在6周、6个月和12个月时的影像学愈合率及活动范围具有可比性,差异无统计学意义(p>0.05)。与LCPDHP组相比,LCP关节外钢板的费用和手术时间显著更少(p<0.05)。
肱骨远端关节外锁定钢板的应用范围可扩展至关节内骨折。它能取得良好效果,并显著降低费用和手术时间。