Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach
Abstract Background Due to the intraarticular and complex nature of the coronal shear fracture of the humeral capitellum and its rarity, it has been difficult to formulate a universally accepted method of surgical management. The purpose of this study is to retrospectively evaluate the clinical outc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-018-2024-8 |
| _version_ | 1798043776305856512 |
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| author | Tengbo Yu Hao Tao Fenglei Xu Yanling Hu Chengdong Zhang Guangjie Zhou |
| author_facet | Tengbo Yu Hao Tao Fenglei Xu Yanling Hu Chengdong Zhang Guangjie Zhou |
| author_sort | Tengbo Yu |
| collection | DOAJ |
| description | Abstract Background Due to the intraarticular and complex nature of the coronal shear fracture of the humeral capitellum and its rarity, it has been difficult to formulate a universally accepted method of surgical management. The purpose of this study is to retrospectively evaluate the clinical outcomes of 15 patients with isolated coronal shear fractures of the capitellum treated by Herbert screw fixation through anterolateral approach, and to address the safety and tips for this surgical procedure. Methods This retrospective study included 15 isolated coronal shear fractures of the capitellum without posterior involvement, which were classified according to the Dubberley classification as 11 type 1A fractures and 4 type 3A fractures. All fractures were treated with Herbert screws fixation via the anterolateral approach. Clinical and radiographic evaluation was performed regularly, with a mean follow-up of 29 months. Results The mean operative time was 81 min. There were no wound healing problems or infection. One incomplete posterior interosseous nerve injury occurred, which recovered soon without residual compromise. All fractures healed well. At the final follow-up, the average range of motion was 134°in flexion-extension and 172°in supination-pronation. There was no significant difference between the affected and the unaffected elbows with regard to motion in flexion-extension or flexion-extension. The average Mayo Elbow Performance Index Score was 93 with 11 excellent and 4 good. No evidence of avascular necrosis, posttraumatic osteoarthritis, or heterotrophic ossification was found. Conclusion Open reduction and internal fixation using Herbert screws through a anterolateral approach is a reliable and effective treatment for coronal shear fractures of capitellum, and able to achieve stable fixation and restoration of a functional range of motion. |
| first_indexed | 2024-04-11T22:54:43Z |
| format | Article |
| id | doaj.art-ac3bc60c52cc4c2eb38243013181dba5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-11T22:54:43Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-ac3bc60c52cc4c2eb38243013181dba52022-12-22T03:58:29ZengBMCBMC Musculoskeletal Disorders1471-24742018-04-011911610.1186/s12891-018-2024-8Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approachTengbo Yu0Hao Tao1Fenglei Xu2Yanling Hu3Chengdong Zhang4Guangjie Zhou5Department of Orthopaedic Surgery, Affiliated Hospital of Qingdao UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Qingdao UniversityDepartment of Radiology, Affiliated Hospital of Qingdao UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Qingdao UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Qingdao UniversityDepartment of Orthopaedic Surgery, Affiliated Hospital of Qingdao UniversityAbstract Background Due to the intraarticular and complex nature of the coronal shear fracture of the humeral capitellum and its rarity, it has been difficult to formulate a universally accepted method of surgical management. The purpose of this study is to retrospectively evaluate the clinical outcomes of 15 patients with isolated coronal shear fractures of the capitellum treated by Herbert screw fixation through anterolateral approach, and to address the safety and tips for this surgical procedure. Methods This retrospective study included 15 isolated coronal shear fractures of the capitellum without posterior involvement, which were classified according to the Dubberley classification as 11 type 1A fractures and 4 type 3A fractures. All fractures were treated with Herbert screws fixation via the anterolateral approach. Clinical and radiographic evaluation was performed regularly, with a mean follow-up of 29 months. Results The mean operative time was 81 min. There were no wound healing problems or infection. One incomplete posterior interosseous nerve injury occurred, which recovered soon without residual compromise. All fractures healed well. At the final follow-up, the average range of motion was 134°in flexion-extension and 172°in supination-pronation. There was no significant difference between the affected and the unaffected elbows with regard to motion in flexion-extension or flexion-extension. The average Mayo Elbow Performance Index Score was 93 with 11 excellent and 4 good. No evidence of avascular necrosis, posttraumatic osteoarthritis, or heterotrophic ossification was found. Conclusion Open reduction and internal fixation using Herbert screws through a anterolateral approach is a reliable and effective treatment for coronal shear fractures of capitellum, and able to achieve stable fixation and restoration of a functional range of motion.http://link.springer.com/article/10.1186/s12891-018-2024-8CapitellumFractureInternal fixationAnterolateral approachHerbert screw |
| spellingShingle | Tengbo Yu Hao Tao Fenglei Xu Yanling Hu Chengdong Zhang Guangjie Zhou Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach BMC Musculoskeletal Disorders Capitellum Fracture Internal fixation Anterolateral approach Herbert screw |
| title | Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach |
| title_full | Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach |
| title_fullStr | Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach |
| title_full_unstemmed | Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach |
| title_short | Management of isolated coronal shear fractures of the humeral capitellum with Herbert screw fixation through anterolateral approach |
| title_sort | management of isolated coronal shear fractures of the humeral capitellum with herbert screw fixation through anterolateral approach |
| topic | Capitellum Fracture Internal fixation Anterolateral approach Herbert screw |
| url | http://link.springer.com/article/10.1186/s12891-018-2024-8 |
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