Objective To investigate the clinical effect of different surgical methods in the treatment of Dubberley Type B humeral capitellum-trochlea fracture. Methods A retrospective case-series study was conducted in 136 patients with humeral cephalic and trochlear fractures treated with Herbert screws or anatomical locking plates(LCP) from January 2017 to December 2023, including 42 males and 94 females aged 30-78 years (mean 54.2 years). According to Dubberley classification, 65 cases were type IB, 52 cases were type IIB and 19 cases were type IIIB. Open reduction and internal fixation were used in all the surgeries, with Herbert screw fixation alone or screw fixation followed by anatomic locking plate fixation. The operative time of the two internal fixation methods were compared. At the last follow-up, the elbow function of the patients was scored using the Mayo Elbow-Performance Score, and the patients' elbow flexion range of motion, forearm internal and external rotation range and complications were recorded. Results Patients were followed up for 10 to 46 months (mean 28.6 months).. The operation time of LCP group was longer than that of Herbert group, and the difference was statistically significant. The Herbert group was superior to the LCP group in terms of postoperative limb extension Angle, elbow flexion Angle and forearm rotation, but the differences were not statistically significant. The postoperative MEPS of the LCP group was lower than that of the Herbert group, but the difference was not statistically significant. Conclusions For type IB, a lateral or posterior approach may be considered, with screw and plate options. For type IIB and Type IIIB, the posterior approach is superior and plate binding screws provide firm fixation.
Key words
Elbow fracture /
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Dubberley classification /
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Open reduction and internal fixation /
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Screw /
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Plate
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