Skip to main content
Log in

Double tension band osteosynthesis in transverse supracondylar distal humerus fractures and nonunions

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the objective and subjective results achieved after double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions in adults.

Methods

Nine patients presenting six fractures and three nonunions of the distal humerus, treated with double tension band wiring between 1998 and 2011, were retrospectively evaluated. Two fractures were type A2 and four type A3, and the nonunions were oligotrophic; all nine lesions had a supracondylar intracapsular transverse orientation, that passed through the olecranon fossa, in a direction parallel to the joint line, and they compromised both columns of the distal humerus. Patient’s age averaged 70 years (range, 56–82).

Results

Follow-up averaged 24.6 months (range, 12–53). All fractures and nonunions united; there were no infections, elbow stiffness or heterotopic bone formations. DASH score at final follow-up averaged 14.2 points (range, 4–22). The analog scale of pain averaged 1.1 points (range, 0–3). Elbow range of motion averaged 100° (range, 100–120°). Flexion averaged 123° (range, 115–130°) and elbow extension loss averaged 15.5° (range, 10–25°).

Conclusions

The results achieved with double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions are comparable to the results that can be expected when using other available fixation methods; this technique is faster, less demanding and cheaper, and surgeons should have it in mind when leading with these particular types of distal humerus fractures and nonunions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Papaioannou N, Babis GC, Kalavritinos J, Pantazopoulos T (1995) Operative treatment of type C intra-articular fractures of the distal humerus: the role of stability achieved at surgery on final outcome. Injury 26:169–173

    Article  PubMed  CAS  Google Scholar 

  2. Ulusal AE, Boz U, Sertoz Z, Ustaoglu RG (2006) Approaches to distal humerus fractures in adults and comparison of treatment results. Acta Orthop Traumatol Turc 40:22–28

    PubMed  Google Scholar 

  3. Nauth A, McKee MD, Ristevski B, Hall J, Schemitsch (2011) Distal humeral fractures in adults. J Bone Joint Surg 93-A:686–700

    Article  Google Scholar 

  4. Sanchez-Sotello J (2012) Distal humerus fractures: role of internal fixation and elbow arthroplasty. J Bone Joint Surg 94-A:556–568

    Google Scholar 

  5. Zhao J, Wang X, Zhang Q (2000) Surgical treatment of comminuted intra-articular fractures of the distal humerus with double tension band osteosynthesis. Orthopaedics 23:449–452

    CAS  Google Scholar 

  6. Houben PFJ, Bongers KJ, Wildenberg FAJM (1994) Double band osteosynthesis in supra- and transcondylar humeral fractures. Injury 25:305–309

    Article  PubMed  CAS  Google Scholar 

  7. Allende CA, Allende BT, Allende BL, Bitar I, Gonzalez G (2004) Intercondylar distal humerus fractures—surgical treatment and results. Chir Main 23:85–95

    Article  PubMed  CAS  Google Scholar 

  8. Schildhauer TA, Nork SE, Mills WJ, Henley MB (2003) Extensor mechanism-sparing paratricipital posterior approach to the distal humerus. J Orthop Trauma 17:374–378

    Article  PubMed  Google Scholar 

  9. Allende C, Allende BT (2009) Post-traumatic distal humerus nonunion. Int Orthop 33:1289–1294

    Article  PubMed  Google Scholar 

  10. Ring D, Jupiter JB, Gulotta L (2003) Articular fractures of the distal part of the humerus. J Bone Joint Surg 85A:232–238

    Google Scholar 

  11. Korner J, Lill H, Muller LP, Hessmann M, Kopf K, Goldhahn J, Gonschorek O, Josten C, Rommens PM (2005) Distal humeral fractures in elderly patients: results after open reduction and internal fixation. Osteoporos Int 16:S73–S79

    Article  PubMed  Google Scholar 

  12. Dogramaci Y, Esen E, Kurklu M, Kirici Y, Atahan AO, Komurcu M (2010) Double plate osteosynthesis provides better biomechanical stabilization than double tension band technique in distal humerus fractures. Eklem Hastalik Cerrahisi 21:44–49

    PubMed  Google Scholar 

  13. Vazquez O, Rutgers M, Ring DC, Walsh M, Egol KA (2010) Fate of the ulnar nerve after operative fixation of distal humerus fractures. J Orthop Trauma 24:395–399

    Article  PubMed  Google Scholar 

  14. Reising K, Hauschild O, Strohm PC, Suedkamp NP (2009) Stabilization of articular fractures of the distal humerus: early experience with a novel perpendicular plate system. Injury 40:611–617

    Article  PubMed  CAS  Google Scholar 

  15. Greiner S, Haas NP, Bail HJ (2008) Outcome after open reduction and angular stable internal fixation for supra-intercondylar fractures of the distal humerus: preliminary results with the LCP distal humerus system. Arch Orthop Trauma Surg 128:723–729

    Article  PubMed  CAS  Google Scholar 

  16. O’Driscoll SW (2005) Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg 14:186S–194S

    Article  PubMed  Google Scholar 

  17. Chen RC, Harris DJ, Leduc S, Borrelli JJ, Tornetta P, Ricci WM (2010) Is ulnar nerve transposition beneficial during open reduction and internal fixation of distal humerus fractures? J Orthop Trauma 24:391–394

    Article  PubMed  Google Scholar 

  18. Dubberley JH, Faber KJ, Macdermid JC, Patterson SD, King GJ (2006) Outcome after open reduction and internal fixation of capitellar and trochlear fractures. J Bone Joint Surg 88A:46–54

    Article  Google Scholar 

  19. Mighell M, Virani NA, Shannon R, Echols EL, Badman BL, Keating CJ (2010) Large coronal shear fractures of the capitellum and trochlea treated with headless compression screws. J Shoulder Elbow Surg 19:38–45

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christian Allende.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Allende, C., Gutierrez, N., Fernandez Savoy, I. et al. Double tension band osteosynthesis in transverse supracondylar distal humerus fractures and nonunions. International Orthopaedics (SICOT) 36, 2565–2569 (2012). https://doi.org/10.1007/s00264-012-1692-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-012-1692-5

Keywords

Navigation