DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20210620

Study on functional outcome of intra articular fractures of distal humerus managed by locking compression plate

Adarsh Krishna Bhat, Tigy Thomas Jacob, Shajimon Sameul

Abstract


Background: The primary goal in management of intra articular fractures of distal humerus is to achieve stable and mobile elbow. Type C fracture of distal humerus is a relatively uncommon fracture. Internal fixation is difficult but anatomical reduction is needed to prevent poor functional outcome and degenerative changes.

Methods: Functional outcome of patients who underwent open reduction internal fixation with locking compression plates for intra articular fractures of distal humerus at the department of orthopedics, Government medical college Kottayam, from December 2017 to July 2019, were assessed using Mayo elbow performance index. A total of 30 patients were studied.

Results: Excellent and good results were found in 25 cases, 3 patients had fair outcome and 2 patients had poor result. Complications encountered in our study were, infection (superficial treated with antibiotics-3 cases), heterotopic ossification (3 cases), hard ware prominence (2 cases) and non-union (1 case).

Conclusions: Complications were minimal and outcomes were good in patients with type C distal humerus fractures who underwent bicolumn locking compression plates fixation by posterior approach.

 


Keywords


Distal humerus intra articular fractures, Locking compression plates, Internal fixation

Full Text:

PDF

References


Rose SH, Melton LJ, Morrey BF, Ilstrup DM, Riggs BL. Epidemiologic features of humeral fractures. Clin Orthop Relat Res. 1982;24-30.

Robinson CM, Hill RM, Jacobs N. Adult distal humeral metaphyseal fracture epidemiology and results of treatment. J Orthop Trauma. 2003;17(1): 38-47.

Sudhir B. Controversies in the management of intra articular fractures of distal humerus in adults. Indian J Orthop. 2011;45(3):216-25.

Henley MB. Intra-articular distal humeral fractures in adults. Orthop Clin North Am. 1987;18:11-23.

Jupiter JB, Neff U, Holzach P, Allgower M. Intercondylar fractures of the humerus. An operative approach. J Bone Joint Surg. 1985;67:226-39.

Letsch R, Chmit-Neuerburg KP, Sturmer KM, Walz M. Intra-articular fractures of the distal humerus. Surgical treatment and results. Clin Orthop. 1989;241:238-44.

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

Holds worth BJ, Mossad MM. Fractures of the adult distal humerus. Elbow function after internal fixation. J Bone Joint Surg. 1990;72:362-5.

John H, Rasso R, Neff U. Operative treatment of distal humeral fractures in the elderly. J Bone Joint Surg. 1994;76:793-6.

Self J, Viegas SF Jr, Buford WL. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg. 1995;4: 10-6.

Karl Stoffel, Sam Cunneen. Comparative stability of perpendicular versus parallel double-locking plating systems in osteoporotic comminuted distal humerus fractures. J Orthop Res. 2008;26:778-84.

Kun-Chuang Wang, Hsin-Nung Shih, Kuo-Yao Hsu. Intercondylar fractures of the distal humerus: routine anterior subcutaneous transposition of the ulnar nerve in a posterior operative approach. J of Trauma. 1994;36(6):770-3.

Liu D, Li P. Investigate the method and clinical effect of double-plating fixation in treatment of distal humerus fractures. Jian Wai Ke Za Zhi. 2010;24(6):680-2.

Gabel GT, Hanson G, Bennett JB. Intraarticular fractures of the distal humerus in the adult. Clin Orthop Relat Res. 1987;216:99-108.

Shin SJ, Sohn HS, Do NH. A clinical comparison of two different double plating methods for intraarticular distal humerus fractures. J Shoulder Elbow Surg. 2010;19(1):2-9.

Ozcr H, Solak S, Turanli S, Baltaci G, Colakoglu T, Bolukbasi S. Clinical effect of double-plating fixation in treatment of distal humerus fractures. Arch Orthop Trauma Surg. 2006;126(8):574.

Henley BM. Intra-articular distal humeral fractures in adults. Orthop Clin North Am Jan. 1987;18(1): 11-23.

Teng-Le Huang, Fang-Yao Chiua, Ticn-Yow Chuangb, Tain-Hsiung Chen. Surgical treatment of acute displaced fractures of adult distal humerus with reconstruction plate Injury. Int J Care Injured. 2004;35:1143-8.

Singh I. Internal fixation of type C fracture of distal humerus. Indian J Orthop. 2004;38(2):110-2.

Rcising K, Hauschild O, Strohm PC, Suedkamp NP. Stabilisation of articular fractures of the distal humerus: early experience with a novel perpendicular plate system Injury. Orthop Clin North Am. 2009;40(6):611-7.

Ring D, Jupiter JB. Fractures of the distal humerus. Orthop Clin North Am. 2000;31:103-13.

Kaiser T, Brunner A, Hohendorff B, Ulmar B, Babst R. Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up. J Shoulder Elbow Surg. 2011;20(2):206-12.

Holub K, Kloub M, Kopačka P. AO type 13-C distal humerus fractures. Results of surgical treatment. Acta Chir Orthop Trauma Cech. 2012;79 (6):529-34.

Lee SK, Kim KJ, Park KH, Choy WS. A comparison between orthogonal and parallel plating methods for distal humerus fractures: a prospective randomized trial. Eur J Orthop Surg Traumatol. 2014;24(7):1123-31.

Krishna R. A study on functional outcome of surgical management of intraarticular fractures of distal humerus. Indian J Orthop Surg. 2015;1(1):57-9.