A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus

Tong-Joo Lee; Young-Tae Kim; Dae-Gyu Kwon; Ju-Yong Park

doi:10.12671/jkfs.2014.27.4.294

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Lee, Kim, Kwon, and Park: A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus

Original Article

Journal of the Korean Fracture Society 2014; 27(4): 294-300.

Published online: 20 October 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.4.294

A Retrospective Comparative Study of Internal Fixation with Reconstruction Plate Versus Anatomical Locking Compression Plate in Displaced Intercondylar Fractures of Humerus

Tong-Joo Lee, M.D., Ph.D., Young-Tae Kim, M.D., Dae-Gyu Kwon, M.D., Ju-Yong Park, M.D.

Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.

Address reprint requests to: Tong-Joo Lee, M.D., Ph.D. Department of Orthopedic Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: 82-32-890-3043, Fax: 82-32-890-3047, TJLEE@inha.ac.kr

Received 30 December 2013 Revised 19 May 2014 Accepted 10 August 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the clinical result of a conventional reconstruction plate (CRP) fixation and locking compressive plate (LCP) fixation on the surgical treatment of an adult's displaced intercondylar fracture of humerus.

Materials and Methods

A total of 40 patients enrolled in the study were treated between August 2002 and May 2012. Fixation with a CRP was performed in 20 patients (group A) and anatomical locking compression plate fixation was performed in 20 patients (group B). The clinical and functional evaluation was performed according to the Mayo elbow performance score and Cassebaum classification of elbow range of motion (ROM), disabilities of the arm, shoulder and hand score.

Results

The Mayo elbow functional evaluation scores, eight cases were excellent, 10 cases were good, and two cases were fair in group A, and 12 cases were excellent, seven cases good, and one case fair in group B; both groups showed satisfactory results. The durations of attaining 90 to 120 degrees of the ROM of joints postoperatively were 8.3 days on average (6 to 15 days) in group A and 5.5 days on average (5 to 9 days) in group B, demonstrating a significant difference between the two groups (p=0.04). Although the correlations of clinical results according to the difference of bone mineral densities (BMDs) were not statistically significant between the two groups (p=0.35), loss of fixation occurred due to loosening of screws in two patients with low BMDs in whose operations reconstruction plates were used.

Conclusion

The use of locking compressive plate on the surgical treatment of an diaplaced intercondylar fracture of humerus have a good clinical results because that permits early rehabilitation through good fixation and reduces the complications such as loosening of screws.

Keywords: Humeral fracture, Intra-articular fractures, Bone plate, Internal fracture fixation, Osteotomy

Figures and Tables

Fig. 1

One case from group A. (A) Initial radiographs show AO/ASIF type C2 fracture of the distal humerus. (B) Postoperative radiographs show a bilateral reconstruction plate through chevron osteotomy of olecranon. (C) At postoperative one year, the patient has excellent range of motion of the elbow from 0° to 150°.

Fig. 2

One case from group B. (A) Initial radiographs show AO/ASIF type C2 fracture of the distal humerus. (B) Postoperative radiographs show a bilateral locking compression plate through chevron osteotomy of olecranon. (C) At postoperative one year, the patient has excellent range of motion of the elbow from 0° to 135°.

Fig. 3

Follow-up radiographs show screw loosening of the lateral reconstruction plate in a patient with low bone mineral densities in whose operations reconstruction plates were used.

Table 1

Mayo Elbow Performance Score

Values are presented as number (%). CRP: Conventional reconstruction plate, LCP: Locking compressive plate.

Table 2

Cassebaums Classification for Elbow Range of Motion

Values are presented as number (%). ROM: Range of motion, CRP: Conventional reconstruction plate, LCP: Locking compressive plate.

Table 3

Other Clinical Results

Values are presented as median (range) or number only. CRP: Conventional reconstruction plate, LCP: Locking compressive plate, DASH: Disabilities of the arm, shoulder and hand, ROM: Range of motion.

Notes

This study was supported by research fund from Inha University, 2014.

Conflict of interest: None.

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