Lateral J-plate fixation in comminuted intercondylar fracture of the humerus.
BACKGROUND
Anatomical reduction and rigid internal fixation of the articular surface is key for functional recovery in types C2 and C3 (AO classification) fractures of the distal humerus. Since these fractures are associated with varying degrees of comminution in both the medial and lateral columns, rigid fixation of both columns is necessary for early mobilization of the elbow joint.


METHODS
We performed a prospective study of the lateral J-plating technique in 17 patients with comminuted intercondylar fracture of the humerus. There were 9 type C2 and 8 type C3 fractures by the AO/ASIF classification. A lateral J-plate was applied along the lateral aspect of lateral column, and the lag screws were inserted into the medial column through the plate hole. A medial reconstruction plate was selectively applied on the posterior aspect of medial column.


RESULTS
All fractures united by 18.7 weeks on average (range 10-28 weeks). Seven patients presented with limitation of motion of the elbow joint, and 5 of them underwent arthrolysis and excision of the heterotopic ossification. The final range of motion of the elbow joint was flexion contracture of 16 deg to further flexion of 121 deg on average. Functional results were excellent in 9 cases, good in 6, fair in 1, and poor in 1 according to Murray's criteria.


CONCLUSIONS
Lateral J-plating with selective augmentation of the medial column provided sufficient rigidity and good clinical results.
Department of Orthopaedic Surgery, BK 21 project for Medical Science, Youngdong Severance Hospital, Yonsei University College of Medicine, Youngdong, PO Box 1217, Seoul, South Korea. kyang@yumc.yonsei.ac.kr
Kyu Hyun
KH
Yang
Hui Wan
HW
Park
Sung Jin
SJ
Park
Sung Hoon
SH
Jung
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013997:Time Factors; D016896:Treatment Outcome