Portal de Periódicos da CAPES

Distal humeral fractures: fixation versus arthroplasty

2011; Elsevier BV; Volume: 20; Issue: 2 Linguagem: Inglês

10.1016/j.jse.2010.11.012

1532-6500

Thomas L. Mehlhoff, James Bennett,

Shoulder Injury and Treatment

The management of the distal humeral fracture in the adult elbow continues to be problematic. The bony anatomy of the distal humerus challenges fixation of the fracture, especially when compromised by comminution and osteoporotic bone. There is little controversy that a well-performed open reduction and internal fixation will yield a superior outcome to the historical "bag of bones" treatment. 15 Gofton W.T. McDermid J.C. Patterson S.D. Faber K.J. King G. Functional outcome of AO type C distal humeral fractures. J Hand Surg Am. 2003; 28: 294-308https://doi.org/10.1053/jhsu.2003.50038 Abstract Full Text Full Text PDF PubMed Scopus (127) Google Scholar , 17 Huang T.L. Chiu F.Y. Chuang T.Y. Chen T.H. The results of open reduction and internal fixation in elderly patients with severe fractures of the distal humerus: a critical analysis of results. J Trauma. 2005; 58: 62-69 Crossref PubMed Scopus (120) Google Scholar , 21 Korner J. Helmut L. Lars P.M. Hessmann M. Kopf K. Goldhahn J. et al. Distal humerus fractures in elderly patients: results after open reduction and internal fixation. Osteoporos Int. 2005; 16: 573-579https://doi.org/10.1007/s00198-004-1764-5 Crossref Scopus (164) Google Scholar , 27 McKee M.D. Wilson T.L. Winston L. Schemitsch E.H. Richards R.R. Functional outcome following surgical treatment of intra-articular distal humeral fractures through a posterior approach. J Bone Joint Surg Am. 2000; 82: 1701-1707 Crossref PubMed Scopus (89) Google Scholar , 41 Riseborough E.J. Radin E.L. Intercondylar T fractures of the humerus in the adult. A comparison of operative and non-operative treatment in twenty-nine cases. J Bone Joint Surg Am. 1969; 51: 130-141 PubMed Google Scholar , 43 Sanchez-Sotelo J. Torchia M.E. O'Driscoll S.W. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique: surgical technique. J Bone Joint Surg Am. 2008; 90: 31-46https://doi.org/10.2106/JBJS.G.01502 Crossref PubMed Scopus (38) Google Scholar , 45 Srinivasan K. Agarwal M. Mathews S.J. Giannoudis P.V. Fractures of the distal humerus in the elderly: is internal fixation the treatment of choice?. Clin Orthop Relat Res. 2005; : 222-230 Crossref PubMed Scopus (95) Google Scholar New techniques for exposure and precontoured plates with locking technology have enhanced the potential for fixation of these fractures. Still, internal fixation using plates is not without complications and sometimes unsatisfying results.