Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Orthopaedics & Traumatology: Surgery & Research Année : 2023

Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture

Résumé

Introduction: There is no "gold standard" for the type of plate to be used for distal extra-articular humeral fractures; the most used is plating of each column. The objective was to evaluate the short-term clinical and radiological results of a Y- anatomical and innovative locking plate (YALP). Hypothesis: The hypothesis is: this anatomical and innovative locking plate will produce satisfactory and reliable results on extra-articular distal humerus fracture superior to double plate fixation. Materials and methods: In a retrospective observational multicenter study, all patients with a distal humerus fracture type 13 A2.2 according to AO classification fixed with a new Y-plate (YALP) were compared to the results of double plate fixation for the same type of fracture. With a follow-up of more than 12 months, the objective and subjective clinical elbow criteria as well as the overall function of the upper limb and radiological assessment were collected. Results: With an average follow up of 24±11 months, 26 patients met the inclusion criteria and received a YALP and 24 patients received double plate. All patients whose fracture had healed except one were pain-free (mean VAS 0.3±0.6). All patients had good subjective results (mean SEV 96%±4). Elbow function was excellent (mean total MEPS 96±4) with normal triceps strength (23/24 patients had a triceps strength graded 5/5 and one patient 4/5) and range of motion (flexion 139±8, extension -7±8 and pronosupination greater than 155 degrees). The operating time was shorter in the YALP group (84 ± 23minutes versus 97 ± 28minutes, p=0.03). The double plate group had more complications; the overall complication rate was significantly higher (p=0.02) in the double 90-degree plate group (12/24, 50%) with four nonunions, four symptomatic ulnar nerves, three hardware removals for pain and one radial nerve injury versus 5/26 complications (19%, p=0.02) in the Y-plate group: one iliac graft for nonunion, 1 plate removal due to functional discomfort, 1 twisted YALP, 1 broke interfragmentary screw and one symptomatic ulnar nerve. DASH, SEV, MEPS scores and flexion-extension range were better in the YALP group. Discussion: YALP produces satisfactory results in supracondylar fractures of the distal humerus. The results of YALP appear to be better than the results with two 90° plates for the same fracture type with a shorter operative time and easier management of fractures with proximal diaphyseal extension.
Fichier non déposé

Dates et versions

hal-04514862 , version 1 (21-03-2024)

Identifiants

Citer

Hugo Barret, Romain Ceccarelli, Paul Vial d'Allais, Matthias Winter, Michel Chammas, et al.. Comparative study of a Y- anatomical and innovative locking plate versus double plate for supracondylar humeral fracture. Orthopaedics & Traumatology: Surgery & Research, 2023, 109 (5), pp.103380. ⟨10.1016/j.otsr.2022.103380⟩. ⟨hal-04514862⟩
0 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More