• Title/Summary/Keyword: Distal humerus fractures

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Clinical Results of Supracondylar Dome Osteotomy for Cubitus Varus and Valgus Deformities in Adults

  • Gwark, Ji-Yong;Im, Jin-Hyung;Park, Hyung Bin
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.229-236
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    • 2016
  • Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was $36.50{\pm}10.22years$. The mean follow-up duration was $54.80{\pm}32.50months$. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were $9.72^{\circ}{\pm}3.95^{\circ}$, $27.67^{\circ}{\pm}10.75^{\circ}$, and $6.92%{\pm}3.40%$, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were $14.73^{\circ}{\pm}2.97^{\circ}$, $11.55^{\circ}{\pm}3.26^{\circ}$, and $11.33%{\pm}6.39%$, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.

Clinical Outcome after Surgical Treatment of Intra-articular Comminuted Fracture of the Distal Humerus in the Elderly: Open Reduction and Internal Fixation Versus Total Elbow Arthroplasty (고령의 상완골 원위부 관절내 분쇄골절의 수술적 치료: 관혈적 정복술 및 내고정술과 일차적 주관절 전치환술의 임상적 결과)

  • Kim, Doo-Sup;Yoon, Yeu-Seung;Yi, Chang-Ho;Woo, Ju-Hyung;Rah, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.130-137
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    • 2012
  • Purpose: To evaluate and report the clinical outcome after surgical treatment of intra-articular comminuted fracture of distal humerus in the elderly with osteoporosis. Materials and Methods: From January 2007 to October 2009, 24 patients aged older than 65 years with intra-articular comminuted fracture of distal humerus underwent surgical treatment. 18 patients (Group I) were managed using primary open reduction and internal fixation (OR IF) through the modified posterior approach and 6 patients (Group II) were taken primary total elbow arthroplasty. The average follow up period was 17.2 months. According to the AO classification, there were 8 C2, 16 C3 type fractures. All enrolled patients were evaluated radiographically and clinically. Clinical outcomes were assessed with the Mayo Elbow Performance, Disabilities of Arm and Shoulder and Hand, and Musculoskeletal Functional Assessment functional questionnaires. Results: The bony union was observed in 18 patients in group I at average 14 weeks. There were 2 patients with neurapraxia of whom the ulnar nerve symptom did not improve despite of anterior transposition. And non-union at osteotomy sites was seen in 2 patients. The mean Mayo Elbow Performance score was 87.0. The mean DASH score was 32.4. The average arc of elbow flexion was $121.0^{\circ}$ (range, $95{\sim}145^{\circ}$) with mean flexion-contracture of $12.0^{\circ}$ (range, 0 to 35). 6 patients in Group II showed no complication during follow up periods. The mean Mayo Elbow Performance score was 89.1. The mean DASH score was 44.3. The average arc of elbow flexion was $125.1^{\circ}$ (range, $100{\sim}145^{\circ}$) with mean flexion-contracture of $12.6^{\circ}$ (range, 0 to 30). Conclusions: With careful patient selection, Total elbow arthroplasty as well as OR IF could achieve good outcomes in elderly of comminuted intra-articular distal humerus fracture with osteoporosis.

Injuries and Prevention methods Associated with In-Line Skate (인라인 스케이트시 발생한 손상 밑 예방)

  • Lim Hong Chul;Chun Seung Joo;Rho Young Jin;Hwang Jin Ho;Park Chan Eung;Kim Tae Un
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.163-167
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    • 2003
  • Purpose: The purpose of this study is to describe causes and injury mechanisms during inline skating and to find preventive measures .Materials and Methods: We have carefully selected 57 patients who have been treated in our hospital and nearby hospital. There are 37 males and 20 females, and mean age is 9 years 9 months (range,6-40 years old) . We have meticulously investigated their injured sites, their favorite location for inline skating , their use of protective means while they were on the wheels and their injury mechanisms . Results: Injury consisted of 50 fractures,1 meniscal tear,2 medial collateral ligament rupture and 4 contusion or sprain. Fracture sites varied as follows : 33(66$\%$) cases in distal radius and ulna,5(10$\%$) in elbow. 3(6$\%$) in diaphysis of humerus, etc Location at the time of injury varied as follows : 22 cases(39$\%$) in their apartment complex, 19 cases in (33$\%$) narrow streets, and 16 cases(28$\%$) in parks Only five patients admitted that any means of protection were used.2 cases only had knee pad on , 1 case put on elbow pad in addition, and 2 cases put on wrist guard as well. However none of the patients had helmet on Conclusion: We would strongly like to stress the importance of using sufficient protections and of choosing area where it is safe to ride, in order to reduce the risk of accidents. In addition, continuous and effective prior education from inline skate circles may be in order before riding the inline skate.

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