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Locking and Non-locking Constructs Achieve Similar Radiographic and Clinical Outcomes for Internal Fixation of Intra-articular Distal Humerus Fractures

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

Locking plates have been used increasingly for the management of distal humerus fractures. Studies that compare patient-centered outcomes between locking and non-locking fixation for distal humerus fractures are lacking.

Questions/Purposes

The purposes of this study were to (1) determine whether locking plates offered superior fixation compared with non-locking plates for distal humerus fractures, (2) determine whether the use of locking plates was associated with fewer complications, and (3) determine whether locking plate use resulted in superior radiographic outcome compared with non-locking plates. Lastly, another aim was to determine the average cost difference associated with locking plate use versus non-locking plate use for distal humerus fracture fixation.

Patients and Method

Demographic, clinical, and radiographic data including loss of fixation, range of motion, rate of infection, nonunion and reoperation, as well as measures of fixation were collected retrospectively and compared on 96 patients with surgically treated AO type 13C distal humerus fractures (65 locking, 31 non-locking) at 6-week and 6-month follow-up. Average costs of locking and non-locking constructs were calculated and compared.

Results

Three in 96 (3.1%) of all cases experienced loss of fixation, with no difference between the two groups. There was no difference between locking and non-locking groups with regard to the rate of nonunion, infection, and reoperation at 6 weeks and 6 months. On average, locking plate constructs were 348% more expensive than non-locking constructs.

Conclusion

While there are some significant differences in radiographic parameters and cost between locking and non-locking constructs for internal fixation of intra-articular distal humerus fractures, there were no statistically significant differences in clinical outcome.

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Acknowledgment

The authors thank Yanna Song for statistical analysis.

Author information

Authors and Affiliations

  1. Massachusetts General Hospital, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, 55 Fruit Street, YAW-2-2C, Boston, MA, 02114, USA

    Kim Brouwer MS & Jesse Jupiter MD

  2. Vanderbilt University, MCE South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA

    William T. Obremskey MD, MPH

  3. DUMC 3466, Durham, NC, 27710, USA

    Grant Garrigues MD, John Solic MD & David Ruch MD

  4. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Marschall Berkes MD

  5. Emory University Medical Center, 49 Jesse Hill Jr. Drive, #307, Atlanta, GA, 30303, USA

    Nader Shourbaji MD

  6. 2323N. Casaloma Drive, P.O. Box 7700, Appleton, WI, 54912-7079, USA

    Nathan Van Zeeland MD

Authors
  1. Marschall Berkes MD
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  2. Grant Garrigues MD
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  3. John Solic MD
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  4. Nathan Van Zeeland MD
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  5. Nader Shourbaji MD
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  6. Kim Brouwer MS
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  7. Jesse Jupiter MD
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  8. David Ruch MD
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  9. William T. Obremskey MD, MPH
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Corresponding author

Correspondence to Marschall Berkes MD.

Additional information

One or more of the authors (WTO) has received funding from The Southeast Fracture Consortium.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

Level of Evidence: Level III, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.

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Berkes, M., Garrigues, G., Solic, J. et al. Locking and Non-locking Constructs Achieve Similar Radiographic and Clinical Outcomes for Internal Fixation of Intra-articular Distal Humerus Fractures. HSS Jrnl 7, 244–250 (2011). https://doi.org/10.1007/s11420-011-9219-y

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  • DOI: https://doi.org/10.1007/s11420-011-9219-y

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