Double tension band osteosynthesis in transverse supracondylar distal humerus fractures and nonunions

Purpose

The purpose of this study was to evaluate the objective and subjective results achieved after double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions in adults.

Methods

Nine patients presenting six fractures and three nonunions of the distal humerus, treated with double tension band wiring between 1998 and 2011, were retrospectively evaluated. Two fractures were type A2 and four type A3, and the nonunions were oligotrophic; all nine lesions had a supracondylar intracapsular transverse orientation, that passed through the olecranon fossa, in a direction parallel to the joint line, and they compromised both columns of the distal humerus. Patient’s age averaged 70 years (range, 56–82).

Results

Follow-up averaged 24.6 months (range, 12–53). All fractures and nonunions united; there were no infections, elbow stiffness or heterotopic bone formations. DASH score at final follow-up averaged 14.2 points (range, 4–22). The analog scale of pain averaged 1.1 points (range, 0–3). Elbow range of motion averaged 100° (range, 100–120°). Flexion averaged 123° (range, 115–130°) and elbow extension loss averaged 15.5° (range, 10–25°).

Conclusions

The results achieved with double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions are comparable to the results that can be expected when using other available fixation methods; this technique is faster, less demanding and cheaper, and surgeons should have it in mind when leading with these particular types of distal humerus fractures and nonunions.