Modified Tension Band Wiring in Adult Distal Humeral Fracture Types A2 and C1

Background: Distal humeral fractures accounts for approximately 2% of all fractures and nearly one-third of humeral fractures in adults. In this regard, Modified Tension Bind Wiring (MTBW) technique was used for the fixation of the distal humeral fractures type A2 and C1 (AO) to evaluate the early movement and complications of the patients. Methods: This study was conducted on 25 patients, who were subjected to open reduction and internal fixation using MTBW techniques, to evaluate the incidence of complications. Results: The mean age of the participants was 53.7 years. Out of 25 patients, 16 cases had C1 and 6 individuals suffered from A2. The mean tourniquet time was 43 min. The mean unio‎n time was 12.24 weeks and the mean duration of the follow-ups was 13.72 months. The mean values for the lack of extension, flexion, and range of motion were 18o, 124o, and 106o, respectively. Wound haematoma and dehiscence were observed in two cases, who were treated after conservative treatment. During 15-90 days, there were no signs of neurapraxia injuries. The non-unio‎n of olecranon osteotomy site was seen in one case, who was treated by the MTBW technique. Since the range of motion was less than 100o in 4 patients, device removal was performed 6 months after the surgery when the range of motion was increased by nearly 12o. Moreover, patients were diagnozed with no serious complications, such as the nonunio‎n of fracture site, malunio‎ns, and deep infection. The radiological examination of the patients revealed the success of their treatment. Conclusion: Based on the obtained results, it can be concluded that MTBW is an effective technique in fracture fixation, which allows gentle early motion. Moreover, this cost-effective technique decreased the surgery duration, tourniquet time, and damage caused by soft tissue stripping. Level of evidence: IV