Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 1 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

3 1 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 3 Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

4 1 Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 3 Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Objectives: This study investigates outcomes and complications of the pin and plate fixation technique, 
which was suggested for distal humerus fractures. It also reports the results of its application in 
nonunions for the first time.
Methods: Forty-nine fracture and 17 nonunion cases who underwent surgery using the technique and were followed 
for at least 18 months were assessed through the range of motion (ROM), Quick Disabilities of the Arm, Shoulder, 
and Hand Score (Quick-DASH), Mayo Elbow Performance Score (MEPS), four-category verbal rating scale (VRS4), and complications.
Results: At the last follow-up, the mean scores of flexion, extension deficit, supination, and pronation ranges in 
fracture cases were 116.7, 22.9, 90.0, and 90.0 degrees, respectively. These values in nonunion cases were 112.2, 
26.4, 86.7, and 85.5 degrees, respectively. The average ROM in fracture cases was 93.8, while it was 85.8 degrees 
in nonunion cases. The mean Quick-DASH in fracture and nonunion patients were 25.2 and 31.1, respectively. 
According to the MEPS, 77.5% of fracture and 64.7% of nonunion patients had excellent and good results. In fracture 
cases, the mean scores of VRS-4 at rest, light activity, and hard activity were 1.3, 1.8, and 2.3, respectively. These 
values in nonunion cases were 1.8, 2.2, and 2.5, respectively. The most common complications were device 
prominence and ulnar neuropathy.
Conclusion: An acceptable union rate and proper elbow function can be expected by using this technique. Owing 
to the promising results of this study, further high-quality studies are recommended. Hereby this technique is called 
Persian Fixation.
 Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 11, Issue 8
August 2023
Pages 503-509

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History

  • Receive Date: 10 December 2022
  • Revise Date: 24 June 2023
  • Accept Date: 10 June 2023

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