Haglin Jack M, Kugelman David N, Lott Ariana, Belayneh Rebekah, Konda Sanjit R, Egol Kenneth A
Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
HSS J. 2022 May;18(2):256-263. doi: 10.1177/15563316211009810. Epub 2021 Apr 27.
: Dual-plating osteosynthesis is the standard treatment for Orthopedic Trauma Association (OTA)-type 13-C distal humerus fractures. However, optimal plate position is debated. : The purpose of this study was to evaluate dual-plate positioning following intra-articular distal humerus fracture repair by comparing outcomes between patients plated in parallel and those plated orthogonally following open-reduction, internal-fixation (ORIF) of intra-articular distal humerus fractures. : All OTA-type 13-C intra-articular distal humerus fractures treated operatively at our institution over a 10-year period were reviewed. Clinical outcomes and complications were compared between those plated in parallel and those plated orthogonally. Data were analyzed using independent-samples -tests, Mann-Whitney tests, chi-square tests, and Fisher's exact tests. : A total of 69 patients met inclusion criteria. Mean follow-up among this cohort was 19.3 months; 45 (64.8%) patients had orthogonal dual plating, and 24 (35.2%) had parallel plating. Groups did not differ with respect to demographics or duration of follow-up. Clinically, there were no significant differences in time to union, elbow arc of motion at any time point, or patient Mayo Elbow Performance Index (MEPI) scores at final follow-up. Furthermore, there were no differences in complications. : Parallel and orthogonal plating following ORIF of distal humerus fractures with modern, contoured locking compression plates had similar outcomes in this study. This study represents the largest comparative series in the literature at the time of its writing. Both techniques may be considered when deciding on dual-plating technique for treating intra-articular distal humerus fractures.
双钢板接骨术是治疗骨科创伤协会（OTA）13 - C型肱骨远端骨折的标准方法。然而，最佳钢板位置仍存在争议。本研究的目的是通过比较关节内肱骨远端骨折切开复位内固定（ORIF）术后平行钢板固定与垂直钢板固定患者的疗效，评估双钢板的放置位置。回顾了我们机构在10年期间手术治疗的所有OTA 13 - C型关节内肱骨远端骨折病例。比较平行钢板固定组和垂直钢板固定组的临床疗效及并发症。采用独立样本t检验、曼 - 惠特尼检验、卡方检验和费舍尔精确检验进行数据分析。共有69例患者符合纳入标准。该队列的平均随访时间为19.3个月；45例（64.8%）患者采用垂直双钢板固定，24例（35.2%）采用平行钢板固定。两组在人口统计学特征或随访时间方面无差异。临床上，骨折愈合时间、任何时间点的肘关节活动弧度或末次随访时患者的梅奥肘关节功能指数（MEPI）评分均无显著差异。此外，并发症方面也无差异。在本研究中，采用现代的、塑形锁定加压钢板对肱骨远端骨折进行ORIF术后，平行钢板固定和垂直钢板固定的疗效相似。本研究是撰写本文时文献中最大的比较系列研究。在决定治疗关节内肱骨远端骨折的双钢板技术时，两种技术均可考虑。
