Purpose: The purpose of this study was to evaluate a new ONI Elbow Plate System for intra-articular fractures of the distal humerus in the elderly.

Methods: 10 elder patients with complete intra-articular distal humerus fractures were treated by our new fixation system. The mean age of our patients was 76 years old (range 70 to 88 years). According to the AO/ASIF system, 6 cases were type C1, three cases were C2 and one case was C3. The ONI transcondylar plate conforms to the anatomical contour of the lateral column of the distal humerus and a locking mechanism between the plate portion and the transcondylar screw and the ONI medial plate conforms to the anatomical contour of the medial one (ONI Elbow Plate System). In all cases the ONI transcondylar plate was used at the lateral side of the fracture site, and either a cannulated cancellous screw (n=3) or an AO one-third tubular plate (n=4) or the ONI medial plate (n=3) at the medial side. The mean period of follow up was 32 months (24 to 48 months).

Results: In all of the 10 cases, complete union was seen on radiographs, and alignment was almost maintained postoperatively. The assessment of results according to the modified Cassebaum’s rating score was 90.4. There were no cases of nonunion or malunion.

Conclusion: Our data showed that the ONI Elbow System for treatment of this fracture in the elderly produced consistently good results even in cases with a small osteoporotic fragment of the distal humerus

We classified fractures of the base of the middle phalanx into five types: 1) single palmar fragment; 2) single dorsal fragment; 3) two main fragments; 4) not involving the articular surface, including epiphyseal separation in children; and 5) all others. Types 1 and 2 were subclassified into avulsion, split and split-depression.

Surgery is recommended for unstable type-1 avulsion fractures, type-2 avulsions which may develop buttonhole deformities, and all fractures which displace articular cartilage surfaces. Long-term follow-up showed that surgical treatment which produced good stability and congruity gave good results. These should be the primary aims of treatment.