DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20212797
Published: 2021-07-28

Functional outcome of surgical management of distal humeral fracture with precontoured anatomical locking plate

Manjunath S. Japatti, Pavith T. Janardhan

Abstract


Background: Intra-articular distal humeral fractures are among the common fractures seen in adults. The cause of injury most commonly being road traffic accidents. These fractures require fixation methods which are technically difficult to achieve a good functional outcome and to minimize complications. This study was useful to analyse the above factors, to come to conclusion.

Methods: This was a prospective study of 20 cases of supracondylar fracture humerus with intercondylar extension treated surgically and assessed for functional outcome, which were admitted to our hospital between 2015 to 2017. Precontoured distal humerus anatomical locking plates were used for fracture fixation with various standard approaches to elbow. Various clinical and functional outcome were analysed at the end using mayo elbow performance score.

Results: Out of 23 patients, 20 patients were available for final follow up and outcome analysis. There were 15 males and 5 females with an average age of 34.4 year (21-50 years). Average time between admission and surgery was 4 days. Clinical and radiological consolidation of fracture was observed in all cases at an average of 12 weeks (9-14 week). The results obtained using mayo elbow performance score were graded as excellent 10 (50%) patients, fair in 6 (30%), poor in 4 (20%). One case had superficial wound infection and managed with IV and oral antibiotics. One patient had transient ulnar nerve palsy managed conservatively and recovered.

Conclusions: Open reduction and internal fixation with anatomical precontoured locking plate is the treatment of choice in comminuted intercondylar distal humerus fractures. specially in young active adults. It provides stable fixation and thereby facilitating early postoperative rehabilitation. However, the outcome mainly depends on restoring the anatomic nature of articular surface along with minimal soft tissue destruction.

 


Keywords


ORIF with precontoured locking plate, Elbow stiffness, Ulnar nerve palsy, Heterotrophic ossification

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References


Galano GJ, Ahmad CS, Levine WN. Current treatment strategies for bicolumnar distal humerus fractures. J Am Acad Orthop Surg. 2010;18(1):20-30.

Nauth A, McKee MD, Ristevski B, Hall J, Schemitsch EH. Current concepts review distal humeral fractures in adults. J Bone Joint Surg Am. 2011;93(7):686-700.

Sanchez-Sotelo J, Torchia ME, O’Driscoll SW. Complex distal humeral fractures: internal fixation with a principle-based parallel-plate technique. J Bone Joint Surg Am. 2007;89(5):961-9.

Gupta RK, Gupta V, Marak DR. Locking plates in distal humerus fractures: study of 43 patients. Chin J Traumatol. 2013;16(4):207-11.

Jupiter JB, Neff U, Holzach P, Allgöwer A. Interondylar fracture of the humerus. an operative approach. J Bone Joint Surg Am. 1985;67(2):226-39.

Gabel GT, Hanson G, Bennett JB, Noble PC, Tullos HS. Intra reticular fractures of the distal humerus in the adult. Clin Orthop Relat Res. 1987;216:99-108.

Henley MB. Intraarticular distal humerus fractures in adults. Orthop Clin North Am. 1987;18(1):11-23.

Wang KC, Shih HN, Hsu KY, Shih CH. Intercondylar fractures of the distal humerus: routine anterior subcutaneous transposition of the ulnar nerve in a posterior operative approach. J Trauma. 1994;36(6):770-3.

Kundel K, Braun W, Wieberneit J, Ruter A. Intraarticular distal humerus fractures. Factors affecting functional outcome. Clin Orthop. 1996;332:200-8.