Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients

Cheon,  Sang Jin; Lee,  Dong Ho; Goh,  Tae Sik

doi:2013.16.1.33

Clin Shoulder Elb > Volume 16(1); 2013 > Article

Original Article

Clinics in Shoulder and Elbow 2013;16(1):33-39.
DOI: https://doi.org/10.5397/CiSE.2013.16.1.33 Published online June 30, 2013.

Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients

Sang Jin Cheon, Dong Ho Lee, Tae Sik Goh

¹Department of Orthopedic Surgery, School of Medicine, Pusan National University, Busan, Korea. scheon@pusan.ac.kr
²Barun Orthopedic Surgery Hospital, Busan, Korea.

고령 환자의 상완골 원위부 AO-C형 골절에서 이중 강선 장력대 고정술

천상진·이동호*·고태식

부산대학교 의학전문대학원 정형외과학교실, 부산 바른 정형외과 병원*

Abstract

PURPOSE
The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. MATERIALS AND METHODS: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index.
RESULTS
Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom.
CONCLUSION
Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

Key Words: Distal humerus fracture; Double tension band osteosynthesis