سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Komijani, Mehdi, Shamabadi, Ahmad, Oryadi Zanjani, Leila, Nabian, Mohammad Hossein, Panjavi, Behnam, Kamrani, Reza Shahriar. (1402). Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus. , 11(8), 503-509. doi: 10.22038/abjs.2023.69446.3268
Mehdi Komijani; Ahmad Shamabadi; Leila Oryadi Zanjani; Mohammad Hossein Nabian; Behnam Panjavi; Reza Shahriar Kamrani. "Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus". , 11, 8, 1402, 503-509. doi: 10.22038/abjs.2023.69446.3268
Komijani, Mehdi, Shamabadi, Ahmad, Oryadi Zanjani, Leila, Nabian, Mohammad Hossein, Panjavi, Behnam, Kamrani, Reza Shahriar. (1402). 'Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus', , 11(8), pp. 503-509. doi: 10.22038/abjs.2023.69446.3268
Komijani, Mehdi, Shamabadi, Ahmad, Oryadi Zanjani, Leila, Nabian, Mohammad Hossein, Panjavi, Behnam, Kamrani, Reza Shahriar. Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus. , 1402; 11(8): 503-509. doi: 10.22038/abjs.2023.69446.3268

Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus

The Archives of Bone and Joint Surgery
مقاله 3، دوره 11، شماره 8، آبان 2023، صفحه 503-509    اصل مقاله (870.04 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2023.69446.3268
نویسندگان
Mehdi Komijani1؛ Ahmad Shamabadi2؛ Leila Oryadi Zanjani3؛ Mohammad Hossein Nabian4؛ Behnam Panjavi1؛ Reza Shahriar Kamrani* 1
1Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
21 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
31 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 3 Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
41 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 3 Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
چکیده
Objectives: This study investigates outcomes and complications of the pin and plate fixation technique, 
which was suggested for distal humerus fractures. It also reports the results of its application in 
nonunions for the first time.
Methods: Forty-nine fracture and 17 nonunion cases who underwent surgery using the technique and were followed 
for at least 18 months were assessed through the range of motion (ROM), Quick Disabilities of the Arm, Shoulder, 
and Hand Score (Quick-DASH), Mayo Elbow Performance Score (MEPS), four-category verbal rating scale (VRS4), and complications.
Results: At the last follow-up, the mean scores of flexion, extension deficit, supination, and pronation ranges in 
fracture cases were 116.7, 22.9, 90.0, and 90.0 degrees, respectively. These values in nonunion cases were 112.2, 
26.4, 86.7, and 85.5 degrees, respectively. The average ROM in fracture cases was 93.8, while it was 85.8 degrees 
in nonunion cases. The mean Quick-DASH in fracture and nonunion patients were 25.2 and 31.1, respectively. 
According to the MEPS, 77.5% of fracture and 64.7% of nonunion patients had excellent and good results. In fracture 
cases, the mean scores of VRS-4 at rest, light activity, and hard activity were 1.3, 1.8, and 2.3, respectively. These 
values in nonunion cases were 1.8, 2.2, and 2.5, respectively. The most common complications were device 
prominence and ulnar neuropathy.
Conclusion: An acceptable union rate and proper elbow function can be expected by using this technique. Owing 
to the promising results of this study, further high-quality studies are recommended. Hereby this technique is called 
Persian Fixation.
 Level of evidence: IV
کلیدواژه‌ها
Fracture fixation؛ Humeral fractures؛ Humerus؛ Humerus nonunion؛ Orthopedic fixation devices
مراجع
1. Beazley JC, Baraza N, Jordan R, Modi CS. Suppl-8, M3: Distal 
Humeral Fractures-Current Concepts. The open orthopaedics 
journal. 2017; 11:1353. doi: 
10.2174/1874325001711011353.
2. Amir S, Jannis S, Daniel R. Distal humerus fractures: a review 
of current therapy concepts. Curr Rev Musculoskelet Med. 
2016; 9(2):199-206. doi: 10.1007/s12178-016-9341-z.
3. Savvidou OD, Zampeli F, Koutsouradis P, et al. Complications 
of open reduction and internal fixation of distal humerus 
fractures. EFORT open reviews. 2018; 3(10):558-567. doi: 
10.1302/2058-5241.3.180009.
4. O’Driscoll SW. Optimizing stability in distal humeral fracture 
fixation. Journal of shoulder and elbow surgery. 2005;
14(1):S186-S194. doi: 10.1016/j.jse.2004.09.033.
5. Doornberg JN, Van Duijn PJ, Linzel D, et al. Surgical treatment 
of intra-articular fractures of the distal part of the humerus: 
functional outcome after twelve to thirty years. JBJS. 2007; 
89(7):1524-1532. doi: 10.2106/JBJS.F.00369.
6. Korner J, Lill H, Müller LP, et al. Distal humerus fractures in 
elderly patients: results after open reduction and internal 
fixation. Osteoporosis international. 2005; 16(2):S73-S79. 
doi: 10.1007/s00198-004-1764-5.
7. Bhashyam AR, Jupiter JB. Revision Fixation of Distal Humerus 
Fracture Nonunions in Older Age Patients with Poor Bone 
Quality or Bone Loss–Is This Viable as a Long-term 
Treatment Option? Arch Bone Jt Surg. 2019; 7(3):251. doi: 
10.22038/ABJS.2018.33009.1872.
8. Fu E, Ring D. Distal humerus nonunion. Shoulder and elbow 
trauma and its complications. Elsevier; 2016:257-267.
9. LaPorte DM, Murphy MS, Moore JR. Distal humerus nonunion 
after failed internal fixation: reconstruction with total elbow 
arthroplasty. Am J Orthop. 2008; 37(10):531-4.
10. Kamrani RS, Mehrpour SR, Aghamirsalim MR, et al. Pin and 
plate fixation in complex distal humerus fractures: surgical  technique and results. International orthopaedics. 2012; 
36(4):839-844. doi: 10.1007/s00264-011-1343-2.
11. Abdoli A, Farhoud AR, Kamrani RS. Treatment of Distal 
Humerus Articular Fracture with Pin-and-Plate Technique. 
The Journal of Hand Surgery (Asian-Pacific Volume). 2020; 
25(03):332-339. doi: 10.1142/S242483552050037X.
12. Müller ME, Nazarian S, Koch P. Classification AO des 
fractures: les os longs. Springer-Verlag; 1987.
13. Hudak PL, Amadio PC, Bombardier C. Development of an 
upper extremity outcome measure: the DASH (disabilities of 
the arm, shoulder and hand) [corrected]. The Upper 
Extremity Collaborative Group (UECG). Am J Ind Med. Jun 
1996; 29(6):602-8. doi: 10.1002/(SICI)1097-
0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.
14. Morrey BF, An K, Chao E. Functional evaluation of the elbow. 
2000; 5:66-74.
15. Chung T, Prasad K, Lloyd TE. Peripheral neuropathy: clinical 
and electrophysiological considerations. Neuroimaging Clin N 
Am. 2014; 24(1):49-65. doi:10.1016/j.nic.2013.03.023.
16. Thong ISK, Jensen MP, Miro J, Tan G. The validity of pain 
intensity measures: what do the NRS, VAS, VRS, and FPS-R 
measure? Scand J Pain. Jan 26 2018; 18(1):99-107. doi: 
10.1515/sjpain-2018-0012.
17. Theivendran K, Duggan PJ, Deshmukh SC. Surgical treatment 
of complex distal humeral fractures: functional outcome after 
internal fixation using precontoured anatomic plates. J 
Shoulder Elbow Surg. Jun 2010; 19(4):524-32. 
doi:10.1016/j.jse.2009.09.011.
18. Lustenberger T, Leonardy R, Marzi I, Frank J. Outcome after 
surgical treatment of complex elbow fractures: a singlecenter follow-up study. Eur J Trauma Emerg Surg. 2020; 
46(6):1445-1449. doi: 10.1007/s00068-019-01157-7. 
19. Patel J, Motwani G, Shah H, Daveshwar R. Outcome after 
internal fixation of intraarticular distal humerus (AO type B & 
C) fractures: Preliminary results with anatomical distal 
humerus LCP system. J Clin Orthop Trauma. Jan-Mar 2017; 
8(1):63-67. doi:10.1016/j.jcot.2017.02.004.
20. Sanchez-Sotelo J, Torchia ME, O'Driscoll SW. Complex distal 
humeral fractures: internal fixation with a principle-based 
parallel-plate technique. JBJS. 2007; 89(5):961-969. doi: 
10.2106/JBJS.E.01311.
21. Vazquez O, Rutgers M, Ring DC, Walsh M, Egol KA. Fate of the 
ulnar nerve after operative fixation of distal humerus 
fractures. J Orthop Trauma. 2010; 24(7):395-9. 
doi:10.1097/BOT.0b013e3181e3e273.
22. Shearin JW, Chapman TR, Miller A, Ilyas AM. Ulnar Nerve 
Management with Distal Humerus Fracture Fixation: A MetaAnalysis. Hand Clin. Feb 2018; 34(1):97-103. 
doi:10.1016/j.hcl.2017.09.010.
23. Donders JC, Lorich DG, Helfet DL, Kloen P. Surgical technique: 
treatment of distal humerus nonunions. HSS Journal®. 2017; 
13(3):282-291. doi: 10.1007/s11420-017-9551-y.
24. Allende C, Allende BT. Post-traumatic distal humerus nonunion. International orthopaedics. 2009; 33(5):1289-1294. 
doi: 10.1007/s00264-008-0650-8.
25. Cha SM, Shin HD. Open reduction and internal fixation for 
nonunion of extra-articular distal humeral fractures in 
patients 70 years and older. J Shoulder Elbow Surg. 2018; 
27(1):118-125. doi: 10.1016/j.jse.2017.08.024. 
26. Bhashyam AR, Jupiter JB. Revision Fixation of Distal Humerus 
Fracture Nonunions in Older Age Patients with Poor Bone 
Quality or Bone Loss - Is This Viable as a Long-term 
Treatment Option? Arch Bone Jt Surg. 2019; 7(3):251-257. 
doi: 10.22038/ABJS.2018.33009.1872.

آمار
تعداد مشاهده مقاله: 609
تعداد دریافت فایل اصل مقاله: 365