A comparative study of the relationship between the recovery of movement and the anatomical alignment in fractures around the elbow

Manish Raj, Simrat Pal Singh Gill, Ajay Kumar Rajput, Santosh Kumar Singh


Background: The injury around the elbow joint is a common condition in any age group, especially in children as a result of fall, during the course of a child's normal play. The aim of the present study was to study the relationship between the recovery of movements and the anatomical alignment in fractures around the elbow.

Methods: In the present study, 110 cases of fractures around elbow were included. The treatment with conservative or operative procedure depends on the surgeon concerned and his priorities. Sixty-six cases were treated conservatively, and 56 cases required operative intervention. At the time of follow up examination, cases were assessed as to the anatomical and functional point of view according to Flynn's criteria. We evaluated the reduction as per alignment in anteroposterior axis, lateral axis, and angulation. The patients were followed up for over 24 months.

Results: Patients who had good anatomical alignment (grade A) showed 96.87% satisfactory result as compared to the patient who had fair anatomical alignment (91.66%) and poor anatomical alignment (54.54%). Thus in grade A where alignment was up to 76 points, we had satisfactory result in 96.87% patients, where as in grade C where alignment was less than 50 points, the result in 45.5% of patients was poor.

Conclusions: Patients who had good anatomical alignment achieved, showed higher recovery of movement compared to the patient who had fair anatomical alignment and poor anatomical alignment.


Recovery of movement, Anatomical alignment, Fractures around the elbow

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Schemitsch EH, Tencer AF, Henley MB. Biomechanical evaluation of methods of internal fixation of the distal humerus. J Orthop Trauma. 1994;8:468.

Jupiter JB. Complex fractures of the distal part of the humerus and associated complications. Instructional Course Lecture. 1995;44:187-98.

McKee MD, Wilson TL, Winston L. Functional outcome following surgical treatment of intraarticular distal humeral fractures through a posterior approach. J Bone Joint Surg. 2000;82:1701.

Ring D, Bucholz RW, Court-Brown CM, Heckman JD, Tornetta. Rockwood and Green's Fractures in Adults. 2010;7:905-44.

Jupiter JB, Mehne DK. Fractures of the distal humerus. Orthopedics, 1992;15:825-33.

Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children: Sixteen years' experience with long-term follow-up. J Bone Joint Surg Am. 1974;56:263–72.

Court-Brown CM, Aitken SA, Duckworth AD, Clement ND, McQueen MM: The relationship between social deprivation and the incidence of adult fractures. J Bone Joint Surg Am. 2013;95(6):321-7.

King GJW, Morrey BF, An KN. Stabilizers of the elbow. J Shoulder Elbow Surg. 1993;2:165-74.

Sim FH, Morrey BF. The elbow and its disorders. Philadelphia: WB Saunders; 1985: 340-354.

Ackerman G, Jupiter JB. Non-union of fractures of the distal end of the humerus. J Bone Joint Surg (Am). 1988;70:75-83.

Morrey BF. Post-traumatic contracture of the elbow: operative treatment, including distraction arthroplasty. J Bone Joint Surg (Am). 1990;72:60l-18.

Miller AN, Beingessner DM. Intra-articular distal humerus fractures. Orthop Clin North Am 2013;44:35-45.

Gupta N, Kay RM, Leitch K: Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children. J Pediatr Orthop. 2004;24:245.

Kumar R, Kiran E K, Malhotra R, Bhan S. Surgical management of the severely displaced supracondylar fractures of the humerus in children. Injury. 2002;33:517-22.

Yusof A, Razak M, Lim A. Displaced supracondylar fracture of humerus in children—comparitive study of the results of closed and open reduction. Med J Malaysia. 1998;53:52-8.

Oh CW, Park BC, Kim PT, et al. Completely displaced supracondylar humerus fractures in children: results of open reduction versus closed reduction. J Orthop Sci. 2003;8(2):37.

Shoaib M, Hussain A, Kamran H, Ali J. Outcome of closed reduction and casting in displaced supracondylar fracture of humerus in children. J Ayub Med Coll Abbottabad. 2003;15(4):23-5.

Bryce CD, Armstrong AD. Anatomy and biomechanics of the elbow. Orthop Clin North Am. 2008;39(2):141–54.

Lockard M. Clinical biomechanics of the elbow. J Hand Ther. 2006;19(2):72–80.