TOTBİD Dergisi

TOTBİD Dergisi

2012, Cilt 11, Sayı, 1     (Sayfalar: 028-033)

Application of locking plates in distal humeral fractures

Mahmut Kömürcü 1, İsmail Uraş 1, Osman Yüksel Yavuz 1

1 Fatih Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Ankara

DOI: 10.5606/totbid.dergisi.2012.04
Görüntüleme: 82
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İndirme : 37

Distal humerus fractures are one of the most challenging fractures for treatment, accounting for 2% of all types of fractures. The complex anatomical structure of the region and less cancellous bone support for the articular surface may complicate surgery. The experience of the surgeon is of utmost importance for the management of these rarely seen fractures. The main purpose of surgery is to constitute an equilateral triangle by medial column, lateral column and trochlea to restore distal humeral articular surface. Correction of insufficient and unstable surgical fixation is always more challenging than primary fixation surgery. The selection of the implant for the fixation is critical. The ideal implant is a kind of implant which can be applied easily with adequate stability under physiologic stress and anatomical contours, as well as reduced burden for the bone-implant interface. Biomechanical studies have shown that lateral and medial columns should be fixed separately with locking plates to maintain the adequacy of the implants and stability of the fixation in the dual-plate fixation. However, some surgeons positioning of the plates with a 90º-90º angle. On the other hand, several studies have demonstrated that parallel plating with screws which cross fracture zone from medial and lateral to the distal of the fracture in sagittal plane is more effective in supporting the bone structure, compared to perpendicular plating. Secure fixation is essential for early and active mobilization. The surgeon should not perform a surgical operation, unless secure fixation is possible. Adequate surgical technique and higher level of patient compliance may result in good or excellent results with a success rate of 80%.

Anahtar Kelimeler : Biomechanics; distal humeral fracture; locked plate