Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome

BMC Musculoskeletal Disorders

Research Article

Martin Lucke¹  Chlodwig Kirchhoff²  Peter Biberthaler²  Marc Beirer²  Moritz Crönlein²  Dominik Pförringer²  Karl F. Braun²  Sebastian Siebenlist³ 

[1] Department of Trauma Surgery, Chirurgisches Klinikum München Süd, Am Isarkanal 30, 81379, Munich, Germany;Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany;Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany;Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany;

关键词: Distal humeral fracture;    Locking plate;    Anatomical preshaped;    Polyaxial;    Outcome;   

DOI  :  10.1186/s12891-017-1910-9

 received in 2017-09-03, accepted in 2017-12-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundManagement of distal humeral fractures remains to be one of the most challenging aspects in trauma surgery. Low profile plating systems with variable angle screw fixation represent a crucial advancement to the established angular stable locking plates with considerable attention in current research. The aim of the prospective randomized trial was to review the preliminary results and patients’ outcome following treatment with these newly developed implants and to rule out potential differences in fracture treatment of two different plating systems.MethodsTwenty patients with distal humeral fractures (AO 13-A1 – AO 13-C3) were included in the current study since 2014. After completing the randomization plan, patients were distributed into two groups for different variable angle locking plates (DePuy Synthes® VA-LCP vs. Medartis® Aptus Elbow). Functional elbow scoring (ROM, MEPS, QuickDASH) served as primary outcome parameter, while radiological fracture consolidation served as secondary outcome parameter. Follow-ups were conducted 6 weeks, 12 weeks, 6 months and 12 months after the operation.ResultsSeventeen of 20 patients (85%) concluded all follow-up examinations. Postoperative elbow extension deficiencies showed significant differences between the two groups in all follow-up examinations with a mean of Ø 18 +/− 7.4 degrees in the DePuy Synthes® VA-LCP group compared to a mean of Ø 6.5 +/− 7.5 degrees in the Medartis® Aptus Elbow group (p = 0.002) 12 months postoperatively. Functional scoring showed a disparate pattern. The Medartis® Aptus Elbow group achieved significantly better MEP scores during follow-up. However, the analysis of the QuickDash revealed better results of the DePuy Synthes® VA-LCP group in the first half and better results of the Medartis® Aptus Elbow group in the second half of the follow-up examination instead.ConclusionsConsidering the complexity of distal humeral fractures, the usage of anatomically preshaped low profile variable angle locking plates for operative treatment leads to good clinical results. Even though there might be some advances of the Medartis® Aptus Elbow plating system concerning postoperative ROM and elbow function, a consistent difference in the overall clinical outcome between the two plating systems could not be detected.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03272490 Retrospectively Registered 1. September 2017.

【 授权许可】

CC BY   
© The Author(s). 2017