Thorat Babaji, Singh Avtar, Vohra Rajeev, Arshad Mohammad, Mavani Ravi
Department of Orthopaedic Surgery, Amandeep Hospital, Amritsar, India.
Trauma Case Rep. 2021 Feb 10;34:100420. doi: 10.1016/j.tcr.2021.100420. eCollection 2021 Aug.
Surgical management of Extraarticular Distal-third diaphyseal Humerus Fracture (EADHF) poses a dilemma in terms of surgical approach, implant selection and position of the implant due to the availability of various pre-contoured implants and plate configurations. Various studies have described a modified application of anatomic locking plates as a satisfactory method of fixation in the surgical management of EADHF.
This report discusses the modified application of anatomic Distal Medial Tibial locking Plate (DMTP) as an alternative strategy in fixation of an acute extraarticular distal-third diaphyseal fracture of the humerus in a 45-years-old female patient. Bony union was achieved successfully without any malalignment and the patient showed a full recovery with an excellent clinical and outcome at 2-years follow-up.
In EADHF, the use of 3.5 mm DMTP is advantageous as it offers rigid fixation by insertion of more number of 3.5 mm locking bicortical screws and stability in both columns. This promotes biological fracture healing, low rate of complication, early return to work with improvement in clinical function. Therefore, we recommend that pre-contoured 3.5 mm DMTP can be successfully used as an alternative fixation choice for the treatment of EADHF.
由于有多种预塑形植入物和钢板构型可供选择,肱骨远端干骺端关节外骨折(EADHF)的手术治疗在手术入路、植入物选择和植入物位置方面存在两难困境。各种研究已将解剖锁定钢板的改良应用描述为EADHF手术治疗中一种令人满意的固定方法。
本报告讨论了将解剖型胫骨远端内侧锁定钢板(DMTP)改良应用于一名45岁女性患者急性肱骨远端干骺端关节外骨折固定的替代策略。骨折成功实现骨性愈合,无任何畸形,患者在2年随访时完全康复,临床效果极佳。
在EADHF中,使用3.5毫米DMTP具有优势,因为通过插入更多数量的3.5毫米双皮质锁定螺钉可提供坚强固定,并在两柱均具有稳定性。这促进了骨折的生物学愈合,并发症发生率低,可早期恢复工作并改善临床功能。因此,我们建议预塑形的3.5毫米DMTP可成功用作治疗EADHF的替代固定选择。