Comparison of clinical outcomes between young and elderly patients with humeral intercondylar fracture treated by either parallel or orthogonal double plating
10.3760/cma.j.issn.1671-7600.2019.09.013
- VernacularTitle: 平行或垂直双钢板构型切开复位内固定治疗青年与老年肱骨髁间骨折的疗效比较
- Author:
Kehan HUA
1
;
Chen CHEN
;
Ting LI
;
Yejun ZHA
;
Maoqi GONG
;
Xieyuan JIANG
;
Weitong SUN
;
Shuai LU
Author Information
1. Department of Orthopaedic Trauma, Jishuitan Hospital, Beijing 100035, China
- Publication Type:Clinical Trail
- Keywords:
Humeral fractures;
Young people;
Elderly;
Fracture fixation, internal;
Bone plates
- From:
Chinese Journal of Orthopaedic Trauma
2019;21(9):810-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes between young and elderly patients with humeral intercondylar fracture treated by open reduction and internal fixation (ORIF) with either parallel or orthogonal double-plate.
Methods:From January 2013 to December 2017, 54 patients with humeral intercondylar fracture were treated at Department of Orthopedic Trauma, Jishuitan Hospital by ORIF with anatomical locking compression plate (LCP) (either parallel or orthogonal double-plate configuration). According to their age, the patients were divided into a young group (from 18 to 30 years old) of 29 cases with an age of 25.5±3.6 years and an elderly group (≥60 years old) of 25 cases with an age of 67.1±5.8 years. The 2 groups were compared in terms of perioperative data, ranges of motion (flextion, extension and rotation), numeric rating scale for pain (NRS), Mayo Elbow Performance Score (MEPS) and quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) at the last follow-up, complications and secondary surgery.
Results:The 2 groups were comparable because there were no significant differences in the preoperative general data except in injury energy, combined injury and gender between them (P>0.05). The young group had significantly more cases of high-energy injury and combined injuries than the elderly group(P<0.05). All patients were followed up for 33.6±15.0 months (from 12 to 63 months). The total blood loss in the elderly group (643.9±298.7 mL) was significantly less than that in the young group (953.9±554.6 mL) (P<0.05). At the last follow-up, there were no significant differences between the 2 groups in ranges of motion, NRS or MEPS (P>0.05), but the elderly group had significantly higher Quick-DASH scores (13.9±14.4 points) than the young group (5.7±8.9 points) (P<0.05). There was no significant difference in postoperative elbow stiffness or postoperative ulnar nerve symptoms betwee the 2 groups (P>0.05), but the rate of secondary surgery in the young group (37.9%, 11/29) was significantly higher than that in the elderly group (4.0%, 1/25) (P<0.05).
Conclusions:In the treatment of humeral intercondylar fractures, ORIF with LCP (either parallel or orthogonal double-plate configuration) can lead to similarly safe and effective clinical outcomes for both young and elderly patients.
