Article
Assessment of supracondylar humeral fractures in elderly patients with double tension bond wiring method – A prospective study with six month follow up
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Authors
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A. Moradi
- Department of Orthopedic surgery, Tabriz University of Med. Sciences, Tabriz
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Y. Hashemi Aghdam
- Young Researchers and elite club, Tabriz Branch, Islamic Azad University, Tabriz
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A. M. Navali
- Department of Orthopedic surgery, Tabriz University of Med. Sciences, Tabriz
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F. Karimi
- Tabriz University of Medical Sciences, Tabriz
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S. Rahimi
- Medical Faculty, Islamic Azad University, Tabriz-Branch
| Published: | March 21, 2014 |
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Outline
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Introduction: One of the causes of limitation in range of motion of the elbow joint in old patients is supracondylar humeral fractures. Although it is not common in old patients but it is so important because of the need to start motions sooner and not to have stiff elbow on the basis of its rigid fixation. There are some methods for its treatment like ORIF with double plating, ORIF with locking plate and ORIF with pinning & plating, but there is no a standard method in all cases. Due to the rising incidence of osteoporotic fractures from low-energy falls in the elderly, we decided to assay the efficacy of double tension bond wiring in distal humeral fractures.
Material and methods: 18 patients over 65 years of age with distal humeral fracture type A2 and C1 (On the basis of OTA classification); treated by double tension bond wiring method had been studied and followed in Shohada hospital since 2008. 12 cases were A2 type and 4 cases were C1 type, also 14 cases were closed fracture and 2 cases were open Fracture Gastilo type 1. Operation with medial & lateral approach is performed; the mean time of operation was 55 minutes. The motion of the joint started after some days after operation, but it was not possible to follow two patients up. In C1 type fracture, Intra articular parts of fracture were fixed by screw. 4 patients were done coronary artery bypass, 4 patients were Diabetic and a patient was diagnosed Chronic Renal Failure.
Results: All of the patients had the radiological union marks after three months. There was not any non union or mal union case. The range of motion after treatment was 100°. All of the patients were able to put their hands on top of their heads. The mean limitation of extension was 30°. Mild bursitis in pins tracts was seen in 5 cases that limited by taking the pins off. There was not any evidence for deeper infections and osteomylitis. After six months, all of the pins were taken off by local anesthesia. Except one patient, all of the patients were satisfied by the result of the operation.
Conclusion: Although this plan isn’t gold standard treatment for distal humeral fracture but, because of short operation time, without special instrumentation, fixation and treatment of it with double tension bond wiring method in old, osteoporotic patients with co- morbidities can be a good treatment method.
