SURGICAL TREATMENT OF DISPLACED INTERCONDYLAR T- OR Y-FRACTURES OF HUMEROUS IN ADULTS

Abstract

In many cases, treatment of intercondylar T- or Y- fractures of numerous is complex, technically difficult and consideration to many factors is needed.

The purpose of this study was to review the results of treatment in 20 isolated fractures in 20 patients that were operated between 1991 and 2001. All patients were operated as soon as possible after the laboratory studies were completed. In no case there was a delay beyond the 5th fracture day. The mean age of the patients was 48.4 years and men to women ratio was 6/1. The fractures were closed, type III according to Riseborough and Radin classification. In 8 cases the fracture was fixed with one 3.5 compression plate with lag screws. In 12 cases two 3.5 compression plates oriented in two planes at 90° angles to each other were needed for fixation. The posterior approach included chevron osteotomy of the olecranon and exposure of the ulnar nerve. Minimum follow up period was 9 months. The time needed for the sound union of the fracture, range of motion and elbow axis were some of the factors that were examined.

Five of the eight fractures that were fixed with one plate achieved union in the expected period of time. In two cases delayed union and malalignment was noticed without the need for surgical intervention. In one case grafts were needed to help the union of the osteotomy site. We had one case of myossitis ossificans. All fractures that were fixed with two plates achieved union without any complications. In one case there was a 30° extension lag of the elbow. The rest of the patients, in both groups had a satisfactory range of motion with an extension lag less than 10°.

Conclusions: dual plate fixation of these fractures has a lower non union rate, permits secure fixation, earlier rehabilitation and generally, is superior than one plate fixation.