고령 환자의 상완골 원위부 AO-C형 골절에서 이중 강선 장력대 고정술

Abstract

Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.