title: Double-locking precontoured plating system for malunited fractures of the distal end of humerus.
abstract: BACKGROUND
  Distal humeral malunions are uncommon injuries, often associated with limited elbow motion, pain, instability, weakness, and sometimes ulnar neuritis. The complex anatomy of the elbow joint makes this condition one of the most complex elbow injuries to treat.
  
  
  METHODS
  Four patients were treated by the same surgeon between 2011 and 2013 using a double-locking precontoured plating system for malunited intra-articular or extra-articular fractures of the distal end of the humerus.
  
  
  RESULTS
  At a mean 3 years of follow-up, a significant improvement in the elbow motion and functional outcome, evaluated with the Mayo Elbow Performance Index and the Disability of the Arm, Shoulder, and Hand, were observed. Articular reduction obtained after the surgery was maintained in all patients without evidence of avascular necrosis. No other complications (i.e., infection, nervous iatrogenic lesions) were reported.
  
  
  CONCLUSIONS
  Corrective osteotomy using double-locking precontoured plating system preceded by preoperative planning using a CT scan allowed an improvement in the functional outcome and elbow motion, without complications.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy. tarallo.luigi@policlinico.mo.it.
authors.forename: L
authors.initials: L
authors.lastname: Tarallo
authors.affiliation: Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Mugnai
authors.affiliation: Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rocchi
authors.affiliation: Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Rovesta
authors.affiliation: Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catani
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: Corrective osteotomy; Distal humerus; Elbow; Fracture; Malunion; Outcome