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

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 ۱۷ nonunion cases who underwent surgery using the technique and were followed for at least ۱۸ 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 (VRS۴), and complications.Results: At the last follow-up, the mean scores of flexion, extension deficit, supination, and pronation ranges in fracture cases were ۱۱۶.۷, ۲۲.۹, ۹۰.۰, and ۹۰.۰ degrees, respectively. These values in nonunion cases were ۱۱۲.۲, ۲۶.۴, ۸۶.۷, and ۸۵.۵ degrees, respectively. The average ROM in fracture cases was ۹۳.۸, while it was ۸۵.۸ degrees in nonunion cases. The mean Quick-DASH in fracture and nonunion patients were ۲۵.۲ and ۳۱.۱, respectively. According to the MEPS, ۷۷.۵% of fracture and ۶۴.۷% of nonunion patients had excellent and good results. In fracture cases, the mean scores of VRS-۴ at rest, light activity, and hard activity were ۱.۳, ۱.۸, and ۲.۳, respectively. These values in nonunion cases were ۱.۸, ۲.۲, and ۲.۵, 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:

Fracture fixation , Humeral fractures , humerus , Humerus nonunion , Orthopedic Fixation Devices