Comparison of perpendicular or parallel double plate fixation to treat AO type C fractures of the distal humerus in adults

Objective To explore the surgical management and clinical effects in adult patients with AO type C fractures of the distal humerus treated with perpendicular or parallel double plating methods through posterior approach. Methods From Jul. 2005 to Nov. 2012,54 adult patients with type C fractures of the distal humerus were treated using double plating method through posterior approach. Eighteen cases were treated through paratricipital approach and 36 through olecranon osteotomy approach; 14 cases were fixed with parallel double plates and 40 with perpendicular double plates. According to the AO / ASIF classification,there were 13 cases of type C1,23 cases of type C2 and 18 cases of type C3. Results Forty-six patients were followed up for 5-28 months( average 14. 6 months). All fractures healed. The healing time was 12-20 weeks( average 15. 4 weeks). There was no incision infection and failure of osteosynthesis. According to the Cassebaum scoring system,there were 14 excellent cases,29 good,6 fair and 5 poor. The excellent and good rate was 79. 6%. In parallel double plating group,there were 4 excellent cases,7 good and 3 fair. The excellent and good rate was 78. 6%. In perpendicular double plating group, there were 10 excellent cases,22 good,3 fair and 5 poor. The excellent and good rate was 80. 0%. No significant difference was found between the 2 groups( P 0. 05). Conclusion Olecranon osteotomy approach is suited for all type C fractures of the distal humerus in adults. Paratricipital approach is major suited for type C1,C2 fractures with intact central trochlea. Perpendicular or parallel double plating method has advantages of stable fixation,early functional exercise and good clinical effects,and they are all ideal methods for treating AO type C fractures of the distal humerus in adults.