Clinical outcomes for linked fixation of distal humerus fractures: a multicenter study.

Abstract

O'Driscoll popularized the principle of linked column fixation for distal humerus fractures. Despite the linked column concept being widely accepted, there are few reported techniques to accomplish this goal. A novel device was designed based on the principles of linked columns. An interlocking beam is used to connect the medial and lateral plates, creating a unified fixed angle construct. Our primary objective was to report clinical outcomes across multiple institutions for a linking beam used in distal humerus fracture fixation. A retrospective series was collected from 5 institutions for the TiBeam (Skeletal Dynamics) with a minimum follow-up of 6 months. Acute and chronic treatment of distal humerus fracture patterns and all plate configurations were included for analysis. A total of 36 cases were collected at a mean age of 52 years and a mean follow-up of 19.3 months. AO C-type fractures were 56% of the series. The median Mayo Elbow Performance Score was 85 (interquartile range [IQR] 76.3-90), the median DASH was 21.4 (IQR 15.9-30), and the median score on the visual analog scale for pain during activities of daily living was 3.5 (IQR 2-5). An olecranon osteotomy was used in 86% of cases, and an anatomic plate was used for fixation of the osteotomy in 94% of those cases. There were 3 cases of olecranon plate removal for a rate across the series of 13.7%. Our short-term results demonstrate satisfactory clinical outcomes with low rates of revision for distal humerus fracture fixed with a linking beam. Further, the rate of removal for the olecranon osteotomy plate was lower than historical reports for aggregate methods of osteotomy fixation.