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Except for extension deficit, no statistically significant differences were found between the articular simple and articular complex fractures and when comparing the results between patients with and without a major complication.The anatomically precontoured and angular-stable double-plate system provides sufficient immediate postoperative stability to allow early physiotherapy, even in C3-type fractures.With a mean MEPS of 85 points, 36 results (36/39 [92%]) were rated as excellent or good.
Consequently, open reduction and internal fixation (ORIF) is accepted as the gold standard in the treatment of intra-articular distal humerus fractures.
It is well accepted, that plates should be placed at both columns in type C fractures.
The aim of this study was to evaluate the functional results and complications following open reduction and internal fixation of distal humerus type C fractures (AO classification) using an anatomically precontoured, angular-stable double-plate system.
The study is a retrospective analysis of 45 patients with 46 type C fractures. Twelve fractures were open (Gustilo classification). Follow-up was performed on 38 patients with 39 fractures (84%) after 14 months (range, 12–22). Functional results were evaluated using the Mayo Elbow Performance Score (MEPS); the Disabilities of the Arm, Shoulder and Hand score (DASH); and range-of motion (ROM) measurements.
Yet, there is no consensus concerning the orientation of the plates at the columns . Surgical treatment of complex distal humeral fractures: functional outcome after internal fixation using precontoured anatomic plates J Shoulder Elbow Surg 2010 ; 19 : 524-532 [cross-ref]Schmidt-Horlohe K., Bonk A., Wilde P., and al.
The lack of stability and the complex anatomy of the distal humerus led to the development of anatomically preshaped implants that provide good clinical results, although complication rates remained considerably high [16Theivendran K., Duggan P. Functional results after osteosynthesis of the distal humerus fracture with an anatomically precontoured.
There is still controversy concerning the value and proper indications for the use of locking plate systems in the treatment course of distal humerus fractures.
To date, there are no studies comparing conventional plate and angular-stable plate osteosynthesis.
Using these implants, the stability of the osteosynthesis no longer relies on the friction between the underlying bone and the plate resulting from screw torque but rather uses a single-beam construct that converts shear stress into compressive stress [21Korner J., Lill H., Muller L. The LCP-concept in the operative treatment of distal humerus fractures – biological, biomechanical and surgical aspects Injury 2003 ; 34 (Suppl.
2) : B20-B30 [cross-ref]Korner J., Diederichs G., Arzdorf M., and al..Recently, anatomically precontoured and angular-stable implants with extensive distal screw options for double plate osteosynthesis such as the locking compression plate (LCP) distal humerus plate system (LCP DHP, Synthes, Umkirch, Germany) were introduced, promising enhanced stability in complex fractures and an ease in application.Biomechanical studies have proven the advantages of these implants, particularly in reduced bone quality [4Korner J., Diederichs G., Arzdorf M., and al. ]]