Functional results of AO 13C fractures managed with bicolumnar plating in a tertiary care centre of North India
Keywords:Distal humerus, Comminuted fracture, Bicolumnar plating
Background: Distal humerus fractures are associated with many problems like fracture comminution and complex fracture anatomy. Achieving a good functional range of motion at the elbow with stability are the primary objectives in managing a comminuted distal humerus fracture.
Methods: 25 consecutive patients were operated with bicolumnar plating for fracture distal humerus AO type 13C. The patients were kept in follow up for at least six months. Mayo elbow performance (MEP) score and flexion extension arc was calculated to study the outcome.
Results: All patients achieved fracture union with mean MEP score of 73.2 and mean flexion extension arc of 93º. This was within the functional range of elbow. Stiffness was observed to be most common complication.
Conclusions: Our study concluded that internal fixation with bicolumnar plating offers good functional results in comminuted intra-articular fractures even in osteoporotic bone with negligible complications.
Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphysical fractures: epidemiology and results of treatment. J Orthop Trauma. 2003;17:38-47.
Virani SR, Sonone S, Dahapute AA, Panda I, Roy KD. Functional Results of Communited Intra-articular Distal Humerus Fractures Treated with Bicolumnar Plating. J Clin Diagn Res. 2017;11(4):1-3.
Doornberg JN, van Duijn PJ, Linzel D, Ring DC, Zurakowski D, Marti RK, et al. Surgical treatment of intra-articular fractures of the distal part of the humerus. Functional outcome after twelve to thirty years. J Bone Joint Surg Am. 2007;89(7):1524-32.
Huang JI, Paczas M, Hoyen HA, Vallier HA. Functional outcome after open reduction internal fixation of intra-articular fractures of the distal humerus in the elderly. J Orthop Trauma. 2011;25(5):259-65.
McCarty LP, Ring D, Jupiter JB.Advances in the management of fractures of the distal humerus and their sequelae. Am J Orthop. 2005;5.
Nauth A, McKee MD, Ristevski B, Hall J, Schemitsch EH. Distal humeral fractures in adults. J Bone Joint Surg Am. 2011;93:686-700.
Morrey BF, An KN. Functional evaluation of the elbow. In: Morrey BF, editor. The elbow and its disorders. 3rd ed. Philadelphia: WB Saunders. 2000;82.
Atalar AC, Demirhan M, Salduz A, Kiliçoğlu O, Seyahi A. Functional results of the parallel-plate technique for complex distal humerus fractures. Acta Orthop Traumatol Turc. 2009;43(1):21-7.
Flinkkila T, Toimela J, Sirni K, Leppilahti J. Results of parallel plate fifixation of comminuted intra-articular distal humeral fractures. J Shoulder Elb Surg. 2014;23(5):701-7.
Coles CP, Barei DP, Nork SE, Taitsman LA, Hanel DP, Henley MB. The olecranon osteotomy: a six-year experience in the treatment of intraarticular fractures of the distal humerus. J Orthop Trauma. 2006;20:164-71.
Kural C, Ercin E, Erkilinc M, Karaali E, Bilgili MG, Altun S. Bicolumnar 90-90 plating of AO 13C type fractures. Acta Orthopaedica et Traumatologica Turcica. 2017;51:128-32.
Khalid MU, Saeed KM, Akhter M. A comparison of functional outcome of intercondylar fracture of distal humerus managed by olecranon osteotomy approach versus triseps sparing approach in adults. J Pak Med Assoc. 2015;65(11):119-22.
Cobb TK, Morrey BF. Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. J Bone Joint Surg Am. 1997;79:826-32.
Gambirasio R, Riand N, Stern R, Hoffmeyer P. Total elbow replacement for complex fractures of the distal humerus. An option for the elderly patient. J Bone Joint Surg Br. 2001;83:974-8.