• Title/Summary/Keyword: Distal humerus fracture

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Biepicondylar Fracture of the Humerus in an Adult Female: A Case Report

  • Seong, Minkyu;Choi, Jungyun;Yum, Jaekwang
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.249-251
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    • 2016
  • iepicondylar fracture of the humerus is very rare in adults. To date, there have been limited evidence of this injury in the English literature. We report a case of a 65-year-old female with a biepicondylar fracture of the left distal humerus without dislocation. Open reduction and internal fixation with K-wires, cannulated screw, and suture anchor were performed. We obtained stability of the elbow and a satisfactory functional outcome. Because this type of injury is associated with varus and valgus instability, operative reduction and fixation are essential in order to gain stability and early recovery of normal function.

Percutaneous K-wire Fixation of Supracondylar Fracture of Humerus in Children (소아 상완골 과상부 골절의 경피적 K-강선 고정술)

  • Shin, Duk-Seop;Ahn, Jong-Chul;Kim, Se-Dong;Lee, Dong-Woo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.400-408
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    • 1993
  • During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safety, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an excellent reduction.

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Hematogenous Osteomyelitis Following Open Fracture in a Cat

  • Hwang, Ya-Won;Lee, Jang-Mi;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.33 no.2
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    • pp.135-137
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    • 2016
  • A 6-month-old, weighing 2.8 kg, female, domestic short-haired cat presented with open fracture at right distal radius about a month ago. Based on radiological findings, hyperplasia at the right radioulna and left humerus was found. Results of the cytological examination were inflammatory reaction and reactive osteoblast. Distal radial ostectomy proceeded with necrotic bone debridement. Three weeks after operation, the radial bone lysis was seen on radiograph but clinical condition improved. Hyperplasia at the right radioulna and left humerus was dissolved. Two months after operation, she can use her both forelimbs despite right elbow have been diagnosed as arthrosclerosis because of periosteal reaction. Six months after operation, clinical symptoms of limbs were not detected. In this case, open fracture was treated through delayed surgical debridement procedure, therefore hematogenous osteomyelitis occurs at another forelimb. The longer a wound remains open, the more likely it is that infection will develop. The infection can occur to fracture bone and seed from hematogenous spread to another normal bone. In conclusion, when open fracture occurs, early antibiotic treatment and urgent surgical intervention are recommended.

Complications of olecranon osteotomy in the treatment of distal humerus fracture

  • Spierings, Kimberley E;Schoolmeesters, Bram J;Doornberg, Job N;Eygendaal, Denise;van den Bekerom, Michel PJ
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.163-169
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    • 2022
  • Distal humerus fractures (DHFs) are challenging to treat due to the locally complex osseous and soft tissue anatomy. Adequate exposure of the articular surface of the distal humerus is crucial when performing an anatomical reconstruction of the elbow. Even though "triceps-on" approaches are gaining popularity, one of the most commonly used surgical treatments for DHF is olecranon osteotomy. The incidence of complications related to this approach is unclear. This review was performed to assess the type and frequency of complications that occur with the olecranon osteotomy approach in the treatment of DHF. A literature search was conducted in the PubMed/Medline, Embase, and Cochrane Library digital databases up to February 2020. Only English articles describing complications of olecranon osteotomy in the treatment of DHF were included. Data on patient and surgical characteristics and complications were extracted. Statistical analysis was performed using SPSS. A total of 41 articles describing 1,700 osteotomies were included, and a total of 447 complications were reported. Of these 447 complications, wound infections occurred in 4.2% of osteotomies, of which 1.4% were deep infections and 2.8% were superficial. Problems related with union occurred in 3.7% of osteotomies, 2% of which represented non-union and 1.7% delayed union. The high risk of complications in olecranon osteotomy must be considered in the decision to perform this procedure in the treatment of DHF.

Treatment for Distal Humeral Fractures by Modified Anatomical Y-Plate (변형된 Y형 해부학적 금속판을 이용한 상완골 원위부 골절의 치료)

  • Moon Eun Sun;Park Jae Hyung;Lee Young Keun
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.51-57
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    • 1998
  • Comminuted fracture of the distal end of the humerus in adults is very rare and difficult to treat. In operative treatment, an implant which can achieve accurate anatoraical reduction and rigid fixation is needed. But the pre­existing Y -shaped plate had wide and thick limbs and some problems in fixation for most distal humeral fractures. So we devised a modified plate which is more narrow and th1n and has a different hole distance and wing length (long lateral wing). The aim of the study was to evaluate the clinical result of this modified anatomical Y -plate. From 1991 to 1997, we treated 23 cases of distal humeral fractures using modified anatomical plate and the results were as follows. 1. Fracture type in 18 patients(78%) was C-type(C1,C2,C3) which were intraarticular and mostly displaced or comminuted. 2. Bony union was obtained in 22 patients(96%) through rigid fixation and observed radiologically at 3.5 months(2-6months) on the average. 3. In 23 patients, 19 patients(82%) showed satisfactory results after 34 months(6-73months) follow-up. So if the modified anatomical Y-plate is used in the treatment of distal humeral fracture, a satisfactory result can be obtained through a more accurate, easy, and rigid fixation than preexisting plate.

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Clinical Outcome after Surgical Treatment of Intra-articular Comminuted Fracture of the Distal Humerus in the Elderly: Open Reduction and Internal Fixation Versus Total Elbow Arthroplasty (고령의 상완골 원위부 관절내 분쇄골절의 수술적 치료: 관혈적 정복술 및 내고정술과 일차적 주관절 전치환술의 임상적 결과)

  • Kim, Doo-Sup;Yoon, Yeu-Seung;Yi, Chang-Ho;Woo, Ju-Hyung;Rah, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.130-137
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    • 2012
  • Purpose: To evaluate and report the clinical outcome after surgical treatment of intra-articular comminuted fracture of distal humerus in the elderly with osteoporosis. Materials and Methods: From January 2007 to October 2009, 24 patients aged older than 65 years with intra-articular comminuted fracture of distal humerus underwent surgical treatment. 18 patients (Group I) were managed using primary open reduction and internal fixation (OR IF) through the modified posterior approach and 6 patients (Group II) were taken primary total elbow arthroplasty. The average follow up period was 17.2 months. According to the AO classification, there were 8 C2, 16 C3 type fractures. All enrolled patients were evaluated radiographically and clinically. Clinical outcomes were assessed with the Mayo Elbow Performance, Disabilities of Arm and Shoulder and Hand, and Musculoskeletal Functional Assessment functional questionnaires. Results: The bony union was observed in 18 patients in group I at average 14 weeks. There were 2 patients with neurapraxia of whom the ulnar nerve symptom did not improve despite of anterior transposition. And non-union at osteotomy sites was seen in 2 patients. The mean Mayo Elbow Performance score was 87.0. The mean DASH score was 32.4. The average arc of elbow flexion was $121.0^{\circ}$ (range, $95{\sim}145^{\circ}$) with mean flexion-contracture of $12.0^{\circ}$ (range, 0 to 35). 6 patients in Group II showed no complication during follow up periods. The mean Mayo Elbow Performance score was 89.1. The mean DASH score was 44.3. The average arc of elbow flexion was $125.1^{\circ}$ (range, $100{\sim}145^{\circ}$) with mean flexion-contracture of $12.6^{\circ}$ (range, 0 to 30). Conclusions: With careful patient selection, Total elbow arthroplasty as well as OR IF could achieve good outcomes in elderly of comminuted intra-articular distal humerus fracture with osteoporosis.

Reconstruction of Triceps Tendon Avulsion Using Mesh Graft and Krackow Suture in a Border Collie

  • Hyeon-Jong Choi;Jong-Hoon Kim;Eunchae Yoon;Tae-Sung Hwang;Hee-Chun Lee;Dongbin Lee;Jae-Hoon Lee
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.378-383
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    • 2022
  • A 3-year-old, 24-kg intact female Border Collie was referred for a toe-touch weight-bearing stance, intermittent weight-bearing lameness, and moderate pain reaction of the right forelimb on physical examination and right humerus olecranon avulsion fracture on diagnostic imaging examination. Surgical repair was performed using tension band wiring to re-attach the triceps tendon and distal olecranon. Migration of the distal olecranon fragment was observed due to comminuted fracture of the fragment 5-days after surgery, and revision surgery was performed. The tension-relieving sutures were passed through the pre-drilled hole in the olecranon, and the polyester mesh was augmented to the suture region, covering the triceps tendon and olecranon drilling hole using the Krackow suture pattern. The elbow joint was immobilized using a type IA transarticular external fixator, which was removed 8 weeks after surgery. Fourteen weeks after surgery, no lameness was observed on gait evaluation. At follow-up after 7 months, the distal olecranon fragment had stabilized, and no lameness was observed.