DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20214051

Functional outcome of AO type C distal humerus fractures treated with internal fixation using olecranon osteotomy in a tertiary care hospital

Simranpreet Singh, Mudasser Arif, Sanjeev Gupta

Abstract


Background: Distal humerus fractures are commonly encountered in the orthopedic emergency. The goals in the treatment of these fractures are aimed at perfect anatomical reduction which could be obtained by open reduction and internal fixation.

Methods: A prospective cohort study was conducted from July 2019 to December 2020 in Government Medical College, Jammu on 35 patients with AO type C distal humerus fractures. Functional outcomes were recorded and evaluated at end of 6 months using mayo elbow performance score (MEPS) score. 3 patients were lost in the follow up and were not included in the study.

Results: 32 patients in the age group 20-65 years were included in the study with a mean age of 42.5 years. Males outnumbered females in ratio of 3:1. Patients undergoing olecranon osteotomy for fixation of distal humerus fractures had mean elbow flexion (121±8.3), loss of elbow extension (10.3±4.2). The functional outcome was made using MEPS score with a mean of 84±8.4 at final follow up.

Conclusions: In this study we concluded that olecranon osteotomy approach provided better outcome. Intraarticular distal humerus fractures was better visualized with olecranon osteotomy approach and allowed early mobilization.


Keywords


AO type C distal humerus, Internal fixation, Olecranon osteotomy

Full Text:

PDF

References


Charissoux JL, Vergnenegre G, Pelissier M, Fabre T, Mansat P. Epidemiology of distal humerus fractures in the elderly. Orthop Traumatol Surg Res. 2013;99(7):765-9.

Morrey BF. Fractures of the distal humerus. Role of elbow replacement. Orthop Clin North Am. 2000;31(1):145-54.

Varecka TF, Myeroff C. Distal Humerus Fractures in the Elderly Population. J Am Acad Orthop Surg. 2017;25(10):673-83.

Dey Hazra R-O, Lill H, Jensen G, Imrecke J, Ellwein A. Fracture-pattern-related therapy concepts in distal humeral fractures Frakturspezifische Therapiekonzepte der distalen Humerus fraktur. Obere Extrem. 2018;13(1):23-32.

Sharma S, John R, Dhillon MS, Kishore K. Surgical approaches for open reduction and internal fixation of intra- articular distal humerus fractures in adults: A systematic review and meta-analysis. Injury. 2018;49(8):1381-91.

Wilkinson JM, Stanley D. Posterior surgical approaches to the elbow: A comparative anatomic study. J Shoulder Elb Surg. 2001;10(4):380-2.

Stoffel K, Cunneen S, Morgan R, Nicholls R, Stachowiak G. Comparative stability of perpendicular versus parallel double-locking plating systems in osteoporotic comminuted distal humerus fractures. J Orthop Res. 2008;26(6):778-84.

Sarkhel S, Bhattacharyya S, Mukherjee S. Condylar orientation plating in comminuted intraarticular fractures of adult distal humerus. Indian J Orthop. 2015;49(5):523-8.

Ali AA, Atkinson HD, Buckley S, Matar HE, Garlick NI. Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev. 2012;10.

The Mayo Clinic Performance Index for the Elbow. J Orthopaed Trauma. 2006;20(8):127.

Bégué T. Articular fractures of the distal humerus. Orthop Traumatol Surg Res. 2014;100:55-63.

Wagener ML, Dezillie M, Hoendervangers Y, Eygendaal D. Clinical results of the re-fixation of a Chevron olecranon osteotomy using an intramedullary cancellous screw and suture tension band. Strateg Trauma Limb Reconstr. 2015;10(1):1.

Schildhauer TA, Nork SE, Mills WJ, Henley MB. Extensor mechanism-sparing paratricipital posterior approach to the distal humerus. J Orthop Trauma. 2003;17(5):374-8.

Islam SU, Glover AW, Waseem M. Challenges and Solutions in Management of Distal Humerus Fractures. Open Orthop J. 2017;11:1292-307.

O’driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg. 2005;14(1):186-94.

Canale ST, Beaty JH. Campbell’s Operative Orthopaedics, 12th edition. Philadelphia: Mosby. 2013;2869.