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Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates

BACKGROUND: The treatment of Dubberley type B capitellar fractures, which are frequently complicated, is widely debated. This study aimed to investigate the prognostic factors and clinical outcomes of Dubberley type B capitellar fractures treated with Herbert screws combined with posterior buttress...

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Autores principales: Gao, Xiang, Li, Hang, Xue, Deting, Pan, Zhijun, Zhang, Yujie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694941/
https://www.ncbi.nlm.nih.gov/pubmed/38044433
http://dx.doi.org/10.1186/s12891-023-07065-7
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author Gao, Xiang
Li, Hang
Xue, Deting
Pan, Zhijun
Zhang, Yujie
author_facet Gao, Xiang
Li, Hang
Xue, Deting
Pan, Zhijun
Zhang, Yujie
author_sort Gao, Xiang
collection PubMed
description BACKGROUND: The treatment of Dubberley type B capitellar fractures, which are frequently complicated, is widely debated. This study aimed to investigate the prognostic factors and clinical outcomes of Dubberley type B capitellar fractures treated with Herbert screws combined with posterior buttress plates. METHODS: Seven men and nine women (aged 30–68 years) with Dubberley type B capitellar fractures were operated on with Herbert screws combined with posterior buttress plates. The patients were classified into Dubberley types IB (seven), IIB (four), and IIIB (five). Complications and bone union were observed, and functional outcomes were evaluated by the Mayo Elbow Performance Index (MEPI). RESULTS: All patients were followed up for a mean period of 23.5 months (12–30 months). All fractures healed in 8–14 weeks (mean, 10.5 weeks). No cases of non-union, elbow instability, or avascular necrosis occurred. Degenerative arthritis occurred in 7 (44%) and heterotopic ossification in 11 (69%) patients. The median MEPI score was 92.5 (interquartile range, 85–100) points, with 11 reporting excellent, 3 good, and 2 fair outcomes. The MEPI scores of type IIIB fractures were significantly lower than those of types IB and IIB fractures, while the MEPI scores of type IB and IIB fractures did not differ significantly. CONCLUSIONS: Dubberley type IIIB capitellar fractures with multiple articular fragments have a poorer prognosis than type IB and IIB fractures. However, Herbert screw fixation combined with posterior metacarpal locking plates is feasible, providing satisfactory recovery of elbow joint function. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-07065-7.
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spelling pubmed-106949412023-12-05 Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates Gao, Xiang Li, Hang Xue, Deting Pan, Zhijun Zhang, Yujie BMC Musculoskelet Disord Research BACKGROUND: The treatment of Dubberley type B capitellar fractures, which are frequently complicated, is widely debated. This study aimed to investigate the prognostic factors and clinical outcomes of Dubberley type B capitellar fractures treated with Herbert screws combined with posterior buttress plates. METHODS: Seven men and nine women (aged 30–68 years) with Dubberley type B capitellar fractures were operated on with Herbert screws combined with posterior buttress plates. The patients were classified into Dubberley types IB (seven), IIB (four), and IIIB (five). Complications and bone union were observed, and functional outcomes were evaluated by the Mayo Elbow Performance Index (MEPI). RESULTS: All patients were followed up for a mean period of 23.5 months (12–30 months). All fractures healed in 8–14 weeks (mean, 10.5 weeks). No cases of non-union, elbow instability, or avascular necrosis occurred. Degenerative arthritis occurred in 7 (44%) and heterotopic ossification in 11 (69%) patients. The median MEPI score was 92.5 (interquartile range, 85–100) points, with 11 reporting excellent, 3 good, and 2 fair outcomes. The MEPI scores of type IIIB fractures were significantly lower than those of types IB and IIB fractures, while the MEPI scores of type IB and IIB fractures did not differ significantly. CONCLUSIONS: Dubberley type IIIB capitellar fractures with multiple articular fragments have a poorer prognosis than type IB and IIB fractures. However, Herbert screw fixation combined with posterior metacarpal locking plates is feasible, providing satisfactory recovery of elbow joint function. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-07065-7. BioMed Central 2023-12-04 /pmc/articles/PMC10694941/ /pubmed/38044433 http://dx.doi.org/10.1186/s12891-023-07065-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gao, Xiang
Li, Hang
Xue, Deting
Pan, Zhijun
Zhang, Yujie
Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title_full Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title_fullStr Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title_full_unstemmed Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title_short Clinical outcomes of capitellar fractures with posterior comminution treated with Herbert screws combined with metacarpal locking plates
title_sort clinical outcomes of capitellar fractures with posterior comminution treated with herbert screws combined with metacarpal locking plates
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694941/
https://www.ncbi.nlm.nih.gov/pubmed/38044433
http://dx.doi.org/10.1186/s12891-023-07065-7
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