Efficacy of three internal fixation methods for type C distal humeral fractures: a comparative study

Objective To compare effects of three internal fixation techniques in treatment of type C distal humeral fractures.Methods The study involved 75 patients with type C distal humeral fractures undergone double tension band fixation (Group A,n =22),vertical dual-plate fixation (Group B,n =27),or parallel dual-plate fixation (Group C,n =26) between January 2003 and October 2010.According to AO classification of fractures,there were five patients with type C1,11 with type C2 and six with type C3 in Group A; four with type C1,13 with type C2 and 10 with type C3 in Group B; seven with type C1,10 with type C2 and nine with type C3 in Group C.Bilateral approach through triceps brachii or olecranon osteotomy following median incision over posterior elbow was undertaken for all the patients.An analysis was made on indices like fixation modes,elbow range of extension and flexion,and complications.In addition,elbow function was assessed according to the modified Cassebaum scoring system.Results All patients were followed up for average 18 months,which showed bone union without wound infection.At the last follow-up,extension and flexion of the elbow was (122.06 ± 13.13)° in Group A,(118.70 ± 12.37)° in Group B,and (119.90 ± 11.79)° in Group C respectively,with no significant differences among groups(P ＞ 0.05).Overall excellence rate was 82％ in Group A,85％ in Group B and 85％ in Group C,respectively (P ＞ 0.05).Conclusion All three internal fixation techniques can attain a good clinical outcome in treatment of type C distal humeral fracture and satisfy the biomechanical requests of distal humerus. Key words: Humeral fractures; Internal fixators; Plates