Document Detail

The use of hinged external fixation to provide additional stabilization for fractures of the distal humerus.
MedLine Citation:
PMID:  17485997     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess improvements in fixation stability when a hinged unilateral external fixator is used to supplement compromised internal fixation for distal humerus fractures. METHODS: Removing a 1-cm section of the distal humerus in cadaveric whole-arm specimens created a comminuted distal humerus fracture model (AO type 13-A3). Fixation was then performed using different constructs representing optimal, compromised, or supplemented internal fixation. Internal fixation consisted of either 2 reconstruction plates with 1, 2, or 3 (optimal) distal attachment screws, or crossing medial and lateral cortical screws. A hinged external fixator was applied in combination with compromised internal fixation. The stability of the different constructs was then evaluated using 3-point bending stiffness and distal fragment displacement measurements during flexion and extension testing. RESULTS: Addition of the external fixator increased the stiffness of all constructs. Stiffness of the compromised reconstruction plate constructs with supplemented fixation was similar to or significantly greater than that of optimal internal fixation. Addition of the fixator to the reconstruction plates with 1 screw or the crossing screws produced displacements of the distal fragment that were similar to those of the compromised constructs alone. However, medial/lateral and anterior/posterior displacements of the distal fragment during flexion and extension of the elbow for supplemented fixation were found to be greater than those for optimal internal fixation. CONCLUSIONS: The use of a hinged external fixator for supplemental fixation of distal humerus fractures may be effective in cases where internal fixation is severely compromised, although displacements may increase above optimal fixation.
Christopher R Deuel; Philip Wolinsky; Eric Shepherd; Scott J Hazelwood
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  21     ISSN:  0890-5339     ISO Abbreviation:  J Orthop Trauma     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-08     Completed Date:  2007-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-9     Citation Subset:  IM    
Department of Mechanical and Aeronautical Engineering, University of California, Davis, California, USA.
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MeSH Terms
Elbow / injuries*
External Fixators*
Fracture Fixation, Internal / methods*
Fractures, Comminuted / surgery*
Humeral Fractures / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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