di displεs kכminet frakshכn dεm na di distal humerus insay big pipul dεm na wan tranga prכblεm bikoz fכ di kכmpleks anatomi fכ di εlbo jכint, sכm sכm frakshכn fragmεnt dεm, εn limited amoun fכ di sכbkכndral bon. di lateral εn mεdial kכlכm dεm na di distal humerus de fכm wan stebul triangul fכm. dis stebul triangul fכm de disrupt afta distal hכmerus frakshכn, spεshal wan kכmpleks AO C-tayp frakshכn.
Usay i kɔmɔt
insay di AO Internal Fixation Technique buk we dεn pכblish insay 1979, fכ comminuted fractures fכ di distal humerus, di AO tim rεkomεnd fכ put di plet dεm 90° to wan an, wan mεdial כ lateral εn wan posita (1).
Teknik step dεm (AO prinsipul dεm fכ frakshכn tritmεnt) .
a: Rikonstrכkshכn fכ di trochlear εn capitellum.
bc: Afta yu ridyus di tri artikul bon fragmεnt dεm, drכl di Kirschner waya na di כpכsite dairekshכn. Yu kin yuz di Kirschner waya as gayd waya fɔ 3.5mm kanul skru, ɔ yu kin put skru paralel to di Kirschner waya.
d: Yuz tεmporari Kirschner waya fכ kכnekt di artikul bon fragmεnt to di humeral shaft
e: fכ fiks di artikul fragmεnt to di humerus, fכs fכ put wan anatomic LCP na di posita sεf fכ di humerus, εn dεn kin put wan plet bihayn di kapitulum we nכ gεt kכtilaj. di mεdial anatomical LCP kin de pan di mεdial kres fכ di humerus fכ εnhans stεbiliti. fכ siriכs bon lכs כ siriכs mεtafizכl kכminishכn, i rεkomεnd fכ put tu LCP dεm na 90° to wan an, biכs dis kכnfigureshכn de gi bεtε bayomεkanikal stεbiliti. Yu fɔ tek tɛm fɔ mek yu nɔ go insay di jɔyn we yu de yuz angle stabilizayshɔn skru.
di anatomi fɔ di humerus
Kɔmpiashɔn fɔ paralel ɛn vertikal stɛl plet dɛn
Insay di 1995 Mɛkaniks Stɔdi we dɛn kɔmpia Dual Plɛt fɔ di Tritmɛnt fɔ Distal Humeral Fraktrɔs, dɛn kɔmpia di ifɛkt dɛn we siks plet plesmɛnt dɛn gɛt (A, dual posita plet; B, posita ulnar plet, latɛral to raydial plet; C, midial ɛn latɛral plet; D, midial to di ulnar plet, posita to di raydial plet; E, mɔdel fɔ di midial ɛn latɛral plet wit skru dεm εn fכ pat frakshכn F, mכdel fכ siriכs kכminet frakshכn wit mεdial εn lateral skru dεm), we de pכynt se plεnti frakshכn dεm kin trit wit dכbl plet dεm na difrεn lכkεshכn tritmεnt, bכt fכ siriכs kכminεt frakshכn, dis stכdi kכnklud se mεdial-latεral plet fiksεshכn we dεn kכmbayn wit skru fiksεshכn de impruv stiffness εn ultimate strכng bכku bכku wan (3).
Ata C (4) et al sho se wan vεtikal plet wit wan posterolateral plet plus fכ 2.7 mm distal skru dεm bin gεt di sem stεbiliti lεk wan paralel plet sistεm in di tritmεnt fכ intra-artikulכr frakshכn dεm na di distal hכmerus. di sikman diskɔmfɔt bikɔs ɔf di skin iritashɔn na di latɛral plet, mɔ di wan dɛn we tan ɛn ol, dɛn kin pul am wit di posterolateral plet.
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