Effects of trochlear fragmentation on functional outcome in coronal shear fractures : a retrospective comparative study

© 2021 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 5(2021), 3 vom: 18. Mai, Seite 571-577
1. Verfasser: Mukohara, Shintaro (VerfasserIn)
Weitere Verfasser: Mifune, Yutaka, Inui, Atsuyuki, Nishimoto, Hanako, Kurosawa, Takashi, Yamaura, Kohei, Yoshikawa, Tomoya, Waki, Takahiro, Kuroda, Tsukasa, Niikura, Takahiro, Kuroda, Ryosuke
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2021
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Arthroplasty Capitellum Coronal shear fracture Dubberley classification Elbow ORIF Trochlea
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520 |a BACKGROUND: Coronal shear fractures of the distal humerus are rare injuries, and fragmentation of the capitellum and trochlea with posterior comminution is challenging for surgeons. We retrospectively evaluated the functional outcomes of patients with coronal shear fractures managed with open reduction and internal fixation, focusing on the number of trochlea fragments in Dubberley type 3B fractures 
520 |a MATERIALS AND METHODS: The functional outcomes of 25 patients, including 8 patients with type 3B fractures, with a mean age (and standard deviation) of 57 ± 20 years, were evaluated at a mean follow-up duration of 15 ± 9 months. Type 3B fractures were classified into two groups: those with two trochlea fragments or less group (group A) and those with three or more fragments (group B). Patient outcomes were assessed with clinical and radiographic examination, range of motion, and the Mayo Elbow Performance scale (MEPS) 
520 |a RESULTS: Two patients with type 3B in group B experienced nonunion, and two patients with type 3B in group A and 1 patient with type 1B demonstrated avascular necrosis on radiographs. The average MEPS score was 96.3 points (range, 70-100), with 18 excellent, 5 good, and 1 fair results. The average range of motion was 10 ± 8 to 130 ± 12. The MEPS score worsened as Dubberley classification progressed from type 1 to type 3 (98.3 vs. 96.7 vs. 88, P = .014, respectively) and subtypes A to B (97.9 vs. 90, P = .014, respectively). In comparing groups A and B, the MEPS score was significantly worse in group B (93.8 vs. 76.3, P = .006) 
520 |a CONCLUSION: Our open reduction and internal fixation results were largely good, although functional outcomes were diminished as Dubberley classification progressed from type 1 to type 3 and subtype A to B. Type 3B fractures with three trochlea fragments or more in the elderly were the most difficult to treat with open reduction and internal fixation and possibly 1-term total elbow arthroplasty 
650 4 |a Journal Article 
650 4 |a Arthroplasty 
650 4 |a Capitellum 
650 4 |a Coronal shear fracture 
650 4 |a Dubberley classification 
650 4 |a Elbow 
650 4 |a ORIF 
650 4 |a Trochlea 
700 1 |a Mifune, Yutaka  |e verfasserin  |4 aut 
700 1 |a Inui, Atsuyuki  |e verfasserin  |4 aut 
700 1 |a Nishimoto, Hanako  |e verfasserin  |4 aut 
700 1 |a Kurosawa, Takashi  |e verfasserin  |4 aut 
700 1 |a Yamaura, Kohei  |e verfasserin  |4 aut 
700 1 |a Yoshikawa, Tomoya  |e verfasserin  |4 aut 
700 1 |a Waki, Takahiro  |e verfasserin  |4 aut 
700 1 |a Kuroda, Tsukasa  |e verfasserin  |4 aut 
700 1 |a Niikura, Takahiro  |e verfasserin  |4 aut 
700 1 |a Kuroda, Ryosuke  |e verfasserin  |4 aut 
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