Treatment in Distal Humerus Fracture with Anatomical Y Plate
Journal of the Korean Fracture Society
Purpose: To evaluate the clinical results of this modified anatomical Y-plate in treatment of distal humerus fracture and factors that affect the results. Materials and Methods: From April 1991 to January 2002, 40 cases (16 male, 24 female) of distal humeral fractures were treated using a modified anatomical Y plate. The patient's age, gender, pain, range of motion, instability, function, bone union, and complication were recorded. Results: At the operation, the mean age of patients is 49.5
... s (12~74 years) and mean follow up period is 18 months (13~82 months). In the range of motion, mean flexion is 122.1 degrees (75~140 degrees) and mean flexion contracture is 11.4 degrees (0~30 degrees). Results by Morrey's functional evaluation include 15 excellent, 23 good and 2 fair cases. There are 2 excellent and 5 good cases in patients of supracondylar fracture which didn't involve the articular surface (A2, A3 type of AO classification), and 13 excellent, 18 good and 2 fair cases in patients of intracondylar fracture which involve the articular surface (B2, C1, C2, C3 type). But there is no statistical significance in results between two groups. There are 3 excellent, 3 good cases in 6 open fracture and 2 excellent, 6 good and 1 fair case in 9 patients with multiple trauma. The patient's age, gender, open fracture, multiple trauma, and intraarticular fracture did not affect the results. Conclusion: Satisfactory results can be obtained if the modified anatomical Y-plate is used to treat a distal humerus fracture, regardless of many factors affecting the results. 나타내는 비교적 드문 골절이나, 주관절에 인접한 상완골 원 위부의 해부학적 특성 때문에 치료하는데 어려움이 많고, 술 후 여러 합병증으로 인하여 예후가 불량한 경우가 많은 골 절이다. 따라서 수술적 치료시 정확한 해부학적 정복과 견고 한 내고정을 얻을 수 있는 내고정물이 필요하다. 상완골 원 위부의 분쇄 골절의 수술적 치료시 정확한 해부학적 정복과 견고한 내고정을 위해 변형된 Y형 금속판을 이용한 방법은 치료 결과에 영향을 미칠 수 있는 여러 요인에도 불구하고 좋은 치료 방법으로 사료되었다. 참 고 문 헌 1) Ackerman G and Jupiter JB: Non-union of Fractures and the distal end of the humerus. J Bone Joint Surg, 70-A: 75-83, 1988. 2) Aitken GK and Rorabeck CH: Distal humeral fractures in the adult. Clin Orthop, 207: 191-197, 1986. 3) Baron JA, Barrett JA and Karagas MR: The epidemiology of peripheral fractures. Bone, 18: 209S-213S, 1996. 4) Brown RF and Morgan RG: Intercondylar T-shaped fracture of the humerus. J Bone Joint Surg, 53-B: 425-428, 1971. 5) Caja VL, Moroni A, Vendemia V, Sabato C and Zinghi G: Surgical treatment of bicondylar fractures of the distal humerus. Injury, 25: 433-438, 1994. 6) Cassebaum WH: Open reduction of T and Y fractures of the lower end of the humerus. J Trauma, 9: 915, 1969. 7) Choi KH, Kang CN, Wang JM and Jang HJ: A clinical study of comminuted fracture of distal humerus in adults. J Korean Orthop Asso, 18: 869-873, 1983. 8) Crenshaw AH: Campbell's operative orthopaedics. 8th ed, Philadelphia, Mosby Co: 1016-1022, 1992. 9) Eastwood WJ: The T shaped fracture of the lower end of the humerus. J Bone Joint Surg, 19-A: 364-369, 1937.