A Comparative Retrospective Analysis of Tension Band Wiring and 3.5 mm Precontoured Plate Used for Fixation of Chevron Osteotomy in Type C Distal Humerus Fractures
| Autor: | Vijay Sharma, Rahul Yadav, Sahil Batra, Siddhartha Maredupaka, Mayur Nayak, Kamran Farooque |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
chevron osteotomy
medicine.medical_specialty medicine.medical_treatment Olecranon Nonunion Elbow Osteotomy distal humerus fractures 03 medical and health sciences Fixation (surgical) 0302 clinical medicine olecranon plate lcsh:Orthopedic surgery medicine Internal fixation 030212 general & internal medicine 030222 orthopedics business.industry Tension band wiring medicine.disease Surgery lcsh:RD701-811 medicine.anatomical_structure nonunion tension band wiring Range of motion business |
| Zdroj: | International Journal of Recent Surgical and Medical Sciences, Vol 6, Iss 02, Pp 53-59 (2020) |
| ISSN: | 2455-0949 2455-7420 |
| DOI: | 10.1055/s-0040-1721540 |
| Popis: | Introduction Complex distal humerus fractures are rare and difficult to treat and traditionally requires an open reduction and internal fixation via a transolecranon approach. However, controversy remains regarding the better method of fixation of the chevron osteotomy. The purpose of the present study was to compare the clinical efficacy of tension band wiring (TBW) and 3.5 mm precontoured plate in treating the chevron osteotomy. Materials and Methods A consecutive series of 49 patients who required olecranon osteotomy for type C distal humerus fractures were identified and grouped according to the construct used. Clinic–radiological evaluation was done at 3 months, 6 months, 1 year, and 2 years. A total of 34 males and 15 females with a mean age of 36.9 ± 12.64 years (18–62 years) were included in the study. Surgical duration, range of motion, Mayo elbow performance score (MEPS), and complications were noted at the follow-up. Results The mean range of motion was initially lower in the plate group (105 degrees ± 9.9 in plate, 107 degrees ± 9.15 in TBW) that subsequently increased at 6 months. The forearm rotation was similar in both the groups. The mean MEPS was found to be higher in the plate group at 2 years (81.83 ± 5.85 in plate, 77.76 ± 8.02 in TBW). A significantly higher rate of complications, that is, nonunion (p = 0.03), loss of reduction (p = 0.03), and revision (p = 0.04) was observed in the TBW group. However, other complications such as symptomatic hardware, wound complication, and removal of hardware were found to be higher in the plate group. Conclusion Both TBW and 3.5 mm precontoured plate provide comparable functional outcomes; however, the complication rate in terms of nonunion, loss of reduction, and revision is seen in the TBW, whereas wound complication and symptomatic hardware are more commonly seen in the plate. |
| Databáze: | OpenAIRE |
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