高齢者の上腕骨遠位端骨折に対するONI transcondylar plateの使用経験

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Purpose : In cases of fracture of the distal end of the humerus in the elderly, dislocation and/or non-union of the joint tend to occur due to fragility of the bones, which makes conventional fixation treatment difficult. Our institution has been employing an ONI trascondylar plate for fractures in patients 70 years and older, and here we evaluated the clinical usefulness of the plate.Materials and Methods : We evaluated 7 elbows of 7 patients (3 men and 4 women) who were treated surgically between June 2005 and August 2008 (mean age at surgery : 80 years, range : 72-85 years). The mean follow-up period after surgery was 11.7 months (range : 2-55 months). AO classification of the fracture type was A2 in 5 patients, A3 in 1 patient, and C2 in 1 patient.Results : The mean postoperative external fixation period was 2.7 weeks (range : 2-4 weeks). Favorable treatment outcome means were obtained, with an elbow motion range of 118 degrees (range : 95-140 degrees) at flexion and -20 degrees (range : -30 to -5 degrees) at extension, and a Japanese Orthopaedic Association (JOA) score of 90.3 points (range : 78-96 points) at final observation. One patient with a C2 fracture type had non-fusion of the bone.Conclusion : An ONI trascondylar plate is considered effective for treatment of distal-end humerus fracture in elderly patients, although an internal plate is considered necessary for AO classification type C fracture.
中国・四国整形外科学会の論文