Comparison On Curative Effects Of Double Plate And Y-shaped Plate In Treatment Of Humeral Intercondylar Fractures

Objective: Through the observation of the curative effect in the treatment of humeralintercondylar fractures by double plate and Y-shaped plate, to systematically evaluate theefficacy and safety of the two kinds of internal fixation methods and to provide referencefor the clinical treatment of humeral intercondylar fractures.Methods: There were46patients with humeral intercondylar fractures who weretreated in Shandong Medical University hospital from March2005to September2012were enrolled in the retrospective study. Those patients had complete clinical data and metthe inclusion criteria. There were18cases of male and28cases of female. All cases weredivided into double plate group and Y-shaped plate group according to different fixationmethods, with29cases in double plate group and17cases in Y-shaped plate group.According to the AO classification, there were10cases of C1-type,22cases of C2-type and14cases of C3-type.6cases of C1-type,14cases of C2-type and9cases of C3-type in doubleplate group and4cases of C1-type,8cases of C2-type and5cases of C3-type in Y-shapedplate group. Accurate assessment of fracture was based on the preoperative imagingexamination, selected the appropriate operation time. All cases used the olecranonosteotomy and positive functional exercises were undertaken Post operation. Curativeeffects of double plate and Y-shaped plate in treatment of humeral intercondylar fractureswere compared in postoperative functional exercise, the time of fracture healing, functionof elbow joint and postoperative complications. Function was evaluated according to Mayoelbow scoring system, and the results were statistically analyzed.Results: All patients were followed up with no cases of omission. All patients werehealed except two cases in Y-shaped plate group because of failure of internal fixation. There was1case of Elbow stiffness in double plates group and2cases in Y-shaped plategroup,1cases of traumatic arthritis in double plates group and2cases in Y-shaped plategroup, tardy ulnar neuritis and heterotopic ossification didn’t appear in the two groups.According to Mayo elbow scoring system, double plate group were excellent in15cases,good in9cases, fair in4cases, and poor in1case with excellent and good rate of82.75%,while Y-shaped plate group were excellent in4cases, good in7cases, fair in4cases, andpoor in2cases, excellent and good rate was64.7%. The results showed that excellent andgood rate of double plate group was significantly higher than that of Y shaped plate group,the difference was statistically significant(P＜0.05).Conclusions:(1) Compared with Y-shaped plate internal fixation in Treatment ofHumeral Intercondylar Fractures, double plate internal fixation provides solid fixation,more stable mechanical properties, and it facilitates rehabilitation exercises.(2) Perfectpreoperative imaging is a premise of the treatment including high-quality X-ray, CT scanand three-dimensional reconstruction, these can correctly assess the comminuted degree offracture, displacement direction.(3) Injury of nerve and vascular should be accuratelyassessed, and pay attention to acra-feeling and blood circulation to avoid missed diagnosisand misdiagnosis.(4) The olecranon osteotomy exposures enough in treatment of HumeralIntercondylar Fractures to avoid the injury to triceps and reduce elbow adhesion afterfixation.(5) Care should be taken to protect the ulnar nerve and routine anteriortransposition to avoid stimulation and compression, and prevent postoperative tardy ulnarneuritis.