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Shear fractures of the distal humerus: Is the use of intra-articular screws a safe treatment?

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Abstract

Background

Coronal shear fractures of the distal humerus are uncommon injuries and are not exempt from complications. The aim of this research is to evaluate the possible advantages and drawbacks using cannulated compression headless screws.

Materials and methods

We performed a prospective study including all the consecutive patients who were treated with cannulated screws for coronal shear fractures of the distal humerus between 2010 and 2013. Following the Dubberley’s classification, three patients were type 1A, one patient was 1B, three patients were 2B, and one patient was 3B. The mean follow-up was 30 months. The clinical and radiological evaluation included analysis of passive range of motion, functional outcome, radiological evaluation of fracture healing and reduction maintenance, and the occurrence of possible adverse events.

Results

All fractures healed, and radiographic union was observed at an average of 3 months. The average elbow range of motion was 125°, with 125° of flexion and 20 of extension. According to the Broberg and Morrey score, there were four excellent and four good results. Using the Mayo Elbow Performance Index, five cases achieved excellent scores and three reported good results. Adverse events reported in three cases were as follows: heterotopic ossification, complex regional pain syndrome and delayed lateral collateral ligament disruption.

Conclusions

The use of cannulated compression headless screws has given satisfactory results, allowing a strong inter-fragmentary compression, early mobilization, with high union rates and good elbow function. However, patients should be counseled about the high proportion of adverse events following these injuries.

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Author’s contribution

Luigi Tarallo designed the research; Luigi Tarallo and Roberto Adani performed the research; Fabio Catani and Carlo Alberto Costanzini analyzed the data; and Raffaele Mugnai and Francesco Zambianchi wrote the paper.

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Authors and Affiliations

  1. Orthopaedics and Traumatology Department, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy

    L. Tarallo, R. Mugnai, F. Zambianchi, C. A. Costanzini & F. Catani

  2. Department of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy

    R. Adani

Authors
  1. L. Tarallo
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  2. R. Mugnai
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  3. R. Adani
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  4. F. Zambianchi
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  5. C. A. Costanzini
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  6. F. Catani
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Correspondence to L. Tarallo.

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All authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tarallo, L., Mugnai, R., Adani, R. et al. Shear fractures of the distal humerus: Is the use of intra-articular screws a safe treatment?. Musculoskelet Surg 99, 217–223 (2015). https://doi.org/10.1007/s12306-015-0386-8

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  • DOI: https://doi.org/10.1007/s12306-015-0386-8

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