DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20193824

The role of open reduction and internal fixation in the treatment of the intercondylar fractures of humerus

Venkata Sivaram G. V., Y. V. S. Prabhakar

Abstract


Background: Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.

Methods: The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.

Results: Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.

Conclusions: Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve.


Keywords


ORIF, Intercondylar fractures, Humerus

Full Text:

PDF

References


Robinson CM, Hill RM, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma. 2003;17:38–47.

Watson–Jones R. Injuries of elbow. In: Wilson JN (ed). Fractures and joint injuries. 7th edition. New Delhi: Elsevier; 2009: 538.

Gupta R. Intercondylar fractures of distal humerus in adults. Injury. 1996;27(8):569–72.

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

John H, Rosso R, Neff U, Bodoky A, Regazzoni P, Harder F. Operative treatment of distal humeral fractures in the elderly. J Bone Joint Surg Br. 1994;76:793–6.

Nauth A, McKee MD, Ristevski B, Hall J, Schemitsch EH. Distal humeral fractures in adults. J Bone Joint Surg. 2011;93:686–700.

Sanchez-Sotello J. Distal humerus fractures: role of internal fixation and elbow arthroplasty. J Bone Joint Surg. 2012;94:556–68.

Athwal GS. Distal humerus fractures. In: Charles M (ed). Rockwood & Green's Fractures in Adults, 8th edition. Phildelphia: Elsevier; 2015: 1237.

Perez EA. Fractures of shoulder arm, forearm. In: Azar FM, Beaty JH, Canale TS (eds). Cambell’s operative orthopedics, 13th edition. Phildelphia: Elsevier; 2017: 2961.

Eastwood WJ. The T-shaped fractures of the lower end of the humerus. J Bone Joint Surg. 1937;19:364-9.

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

Papaioannou N, Babis GC, Kalavritinos J, Pantazopoulos T. Operative treatment of type C intra-articular fractures of the distal humerus: the role of stability achieved at surgery on final outcome. Injury 1995;26:169–73.

Korner J, Lill H, Müller LP, Hessmann M, Kopf K, Goldhahn J, et al. Distal humerus fractures in Elderly patients: results after open reduction and internal fixation. Osteoporos Int. 2005;16(2):73-9.

Charissoux JL, Mabit C, Fourastier J, Beccari R, Emily S, Cappelli M, et al. Comminuted intra-articular fractures of the distal humerus in elderly patients. Rev Chir Orthop Reparatrice Appar Mot. 2008;94:36–62.

Cassebaum WH. Operative treatment of T and Y Fractures of lower end of humerus. Am J Surg. 1952;83(3):265–70.

Cassebaum WH. Open reduction of T and Y Fractures of lower end of humerus J Trauma. 1969;9(11):915–25.

Perez EA. Fractures of shoulder Arm forearm. In: Azar FM, Beaty JH, Canale ST (eds). Campbell’s operative orthopaedics. 13th edition. Philadelphia: Elsevier Publication; 2017: 2961.

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

Gupta R. Intercondylar fractures of distal humerus in adults. Injury. 1996;27(8):569–72.

Gupta R, Khanchandani P. Intercondylar fractures of the distal humerus in adults: a critical analysis of 55 cases. Injury. 2002;33(6):511–5.

Allende CA, Allende BT, Allende BL, Bitar I, Gonzalez G. Intercondylar distal humerus fractures--surgical treatment and results. Chir Main. 2004;23(2):85–95.