Comparative study between bi-columnar plating as opposed to double tension band osteosynthesis in inter-condylar distal humerus fractures in adults

Abstract

Introduction: Distal humerus fractures with inter-condylar extension are unusual in Orthopaedic practice. The treatment for the same has been defined inside the literature and consists of parallel and orthogonal fixation with the aid of using plates. The study aimed to observe the effectiveness of “double tension band wiring” method for the remedy of distal humerus fractures with inter-condylar extension and compare the effects with studies related to its treatment with locking plates. Materials and methods: 50 patients, all presenting with closed fractures of the distal humerus, out of them 20 have been dealt with double tension band wiring procedure and 30 were treated with locked plates fixation method. Results: Out of 50 cases treated with these 2 methods of internal fixation, rigid fixation and union was achieved in each and every patient. The mean duration of use of tourniquet during surgery was 65 minutes with minimum of 54 minutes and maximum of 110 minutes. Complete radiological union of the fracture was seen at a mean duration of 11 weeks after the surgery (9-15 weeks). Average range of motion was 103 degrees with maximum range of motion of 110 degrees (20-130 degrees) and minimum of 65 degrees (25-90 degrees). Good results were obtained in both the groups in our study. Conclusion: Both the approaches of treatment gave good results. Union became accomplished in almost all instances. However, implant related difficulty become more with locked plates. Double tension band is a reliable, easier, inexpensive and safe technique of fixation of inter-condylar fractures of distal humerus in adults.