Objectives: To review the functional outcome of AO type C 2-3 distal humeral fractures and analyze the results of open reduction internal fixation (ORIF) of these injuries.
Methods: We report on a group of 17 patients (12 male, 5 female; mean age 44.5) with comminuted fracture of the distal humerus treated by ORIF. The posterior approach was used in all of patients. The ORIF was performed with double plates in ten patients, lateral plate medial screw or K-wire in six. Additional plate required in one patient. The results were assessed according to Cassebaums scoring system and Mayo elbow performance index (MEPI).
Results: An average of 34.3 (range: 12-65) months after surgery, average elbow flexion was 126.7° (range: 110°-140°), the average loss of extension was 18.8° (range: 0-40°), the average supination was 75° (range: 70°-85°) and average pronation was 74.1° (range: 70- 75°). According to the Cassebaums scoring system, four patients were graded as very good (23.5%), 10 patients were good (58.8%) and three patients were fair (17.7%). The mean MEPI was 80 and results were excellent in five patients (29.4%), good in seven (41.2%) and fair in five (24.4%).
Conclusion: There is no standart treatment for the comminuted distal humeral fractures. Surgical approach, incision, hardware and fixation types should preferred according to fracture type, site and level. Every technique which provides rigid fixation, alingement and early motion can restore elbow motion.
Key words: Humerus, distal, intraarticular
|
