Comparison of two different double-plate fixation methods with olecranon osteotomy for intercondylar fractures of the distal humeri of young adults

Abstract

Although several studies have demonstrated good results with open reduction and internal fixation of intercondylar fractures of the distal humerus, few have specifically addressed the results of such surgical fixation in young adults. The purpose of this study was to compare the clinical outcomes in patients with intercondylar fractures of the distal humerus treated using two different double-plating methods. Twenty-five patients with distal humeral fractures classified as type C according to the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification system, who were admitted to the Second Hospital Affiliated to Anhui Medical University (Hefei, China) from October 2008 to October 2011, were included in the study. The patients were treated with two different double-plate fixation and olecranon osteotomy methods. Thirteen patients were treated by perpendicular plating (group I) and twelve patients by Y-shaped double-plating in the coronal plane (group II). All the patients were followed up for 12–38 months, with an average of 19.2±7.1 months in group I and 18.3±4.0 months in group II. All the osteotomies and fractures had healed by the final follow-up. Complications developed in 4 patients in group I and 3 patients in group II. According to the Mayo Elbow Performance Scores (MEPS), 84.6% of patients in group I and 83.3% in group II had excellent or good scores. No significant differences were identified between the clinical outcomes of the two plating methods. The olecranon osteotomy approach with double-plate fixation is a good choice for the surgical treatment of type C intercondylar fractures in young adult distal humeri. The two plating methods provide solid fixation, permit early rehabilitation and result in satisfactory clinical outcomes.