gms | German Medical Science

Objectives: To discuss the clinical effects of Dubberley B capitellar fracture therapy with vertical or parallel mini locking plate.

Methods: Case group study was used to evaluate patients.17 cases of patients with capitellar fracture cured through operation with vertical or parallel mini locking plate are observed, of which, 12 patients are male and five patients are female, aging from 23 to 77, with average age of 56.4. Those patients include two cases of Dubberley B, six cases of Dubberley II B and nine cases of Dubberley III B. The operations were conducted through Kocher at outside of rear elbow joint and the fractured bone is fixed firstly with kirschner wire and mini screws after resetting and then with vertical or parallel mini locking plate. Observe the curing of fractured bone and the functions of elbow, wrist joint and forearm. The postoperative anteroposterior and lateral film can be used to evaluate the block position of fracture, healing, avascularnecrosis of capitellum, heterotopic ossification, and traumatic arthritis. We used the Mayo elbow score of subjective and objective scoring to evaluate the function of elbow. The same time, we evaluated flexion and extension of elbow, swing of forearm and inside stability of elbow joint.

Results and conclusion: All patients were visited and observed for 12 to 24 months after operation, with average of 21.1 months. Quality of fracture reduction: Include 12 cases of anatomical reduction and five cases of adjacent anatomical reduction. No patient has blood or nerve wound, the wound is healed at phase I within 10 to 12 days after operation. The clinical fracture healing time lasts 8 to 12 weeks, averaged 11.4 weeks. The X-ray detection conducted in the last visit shows the fracture is well healed without complications like fracture reduction loss, looseness or break of interior fixing, ischemic necrosis of the humerus, traumatic arthritis or heterotopic ossification of the elbow joint. MEPS in all patients with 60 to 100 points, an average of 87.6 points. MEPS assessment: excellent in 13 cases, good in 3 cases, 1 case, excellent rate of 94%. At the last follow-up, the average activity of the elbow is 6° (0° ~ 10°), flexion 118° (90° ~ 130°). The average of forearm pronation is 70° (60° ~ 90°). The average of forearm supination is 82° (70° ~ 90°). The inner stress test is not unstable. Conclusion Patient with Dubberley B capitellar fracture cured with vertical or parallel mini locking plate is allowed to make functional exercise after operation and the therapy effect is satisfactory according to clinical visits in short time.