title: Plate and Screw Fixation of Bicolumnar Distal Humerus Fractures: Factors Associated With Loosening or Breakage of Implants or Nonunion.
abstract: OBJECTIVE
  To identify factors associated with reoperation for early loosening or breakage of implants or nonunion after operative treatment of AO type C distal humerus fractures.
  
  
  METHODS
  We retrospectively analyzed 129 adult patients who had operative treatment of an isolated AO type C distal humerus fracture at 1 of 5 hospitals to determine factors associated with reoperation for early loosening or breakage of implants or nonunion.
  
  
  RESULTS
  Within 6 months of original fixation, 16 of 129 fractures (12%) required reoperation for loosening or breakage of implants (n = 8) or nonunion (n = 8). In bivariate analyses, the Charlson comorbidity index, smoking, a coded diagnosis of obesity, diabetes mellitus, and radiographic osteoarthritis were significantly associated with reoperation for early loosening or breakage of implants or nonunion.
  
  
  CONCLUSIONS
  With the numbers available, patient factors rather than technical factors were associated with reoperation for loosening or breakage of implants and nonunion. Because of the relative infrequency of fixation problems and nonunion, a much larger study is needed to address technical deficiencies.
authors: Department of Hand Surgery, Massachusetts General Hospital, Boston, MA.
authors: Femke M A P
authors: FM
authors: Claessen
authors: Department of Hand Surgery, Massachusetts General Hospital, Boston, MA.
authors: Yvonne
authors: Y
authors: Braun
authors: Department of Hand Surgery, Massachusetts General Hospital, Boston, MA.
authors: Rinne M
authors: RM
authors: Peters
authors: Department of Hand Surgery, Massachusetts General Hospital, Boston, MA.
authors: Gregory P
authors: GP
authors: Kolovich
authors: Department of Hand Surgery, Massachusetts General Hospital, Boston, MA. Electronic address: dring@partners.org.
authors: David
authors: D
authors: Ring
mesh_terms: D000328:Adult; D001860:Bone Plates / Q000009:adverse effects; D001863:Bone Screws / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D015601:Injury Severity Score; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Elbow trauma; distal humerus fracture; failure of fixation; nonunion