Clinical outcome of treatment of intra-articular distal humerus fracture with open reduction and internal fixation by orthogonal locking plate: a prospective study

Authors

  • Deepak Vashistha Department of Orthopaedics, BLDEU Shri BM Patil Medical College, Vijayapura, Karnataka, India
  • Sandeep Naik Department of Orthopaedics, BLDEU Shri BM Patil Medical College, Vijayapura, Karnataka, India
  • Santosh Nandi Department of Orthopaedics, BLDEU Shri BM Patil Medical College, Vijayapura, Karnataka, India
  • Shreepad Kulkarni Department of Orthopaedics, BLDEU Shri BM Patil Medical College, Vijayapura, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20201030

Keywords:

Distal humerus, Intra-articular fracture, Orthogonal locking plating, Olecranon osteotomy

Abstract

Background: The aim of the study was to study the clinical outcome and complications of surgical management of intra-articular fractures of distal humerus.

Methods: A prospective study included 23 consented patients with intra-articular distal humeral fractures who underwent osteosynthesis by orthogonal locking compression plating using posterior approach with olecranon osteotomy between November 2017 to May 2019 at BLDE(DU’s) Shri BM Patil Medical College, Vijayapura, Karnataka.

Results: In our study there were 15 male patients and 8 female patients with mean age of 38.5 years. 65.2% of the cases admitted were due to motor vehicle accident, 21.7% due to accidental fall and 13% due to fall from height with right side (73.9%) being the more commonly affected side. The mean operative time was 100 minutes. Mayo Elbow Performance Score was 83.3% post operatively and the mean arc of motion was 117°. 82% of cases fared excellent to good results.

Conclusions: Orthogonal locking plate construct provides stable rigid fixation for allowing early mobilisation and allows predictable healing both clinically and functionally in these complicated fractures. Absence of implant failure and non-union may be attributed to the highly stable construct system achieved by orthogonal locking plating. Majority of our cases had good functional outcome and return to pre injury status.

Metrics

Metrics Loading ...

Author Biography

Deepak Vashistha, Department of Orthopaedics, BLDEU Shri BM Patil Medical College, Vijayapura, Karnataka, India

Post graduate student (3rd year) , Department of Orthopedics, Shri B M Patil Medical College and Research Centre , Vijayapura, 586103

References

Rose SH, Melton LJ, Morrey BF, Ilstrup DM, Riggs BL: Epidemiologic features of humeral fractures. Clin Orthop Relat Res. 1982;168:24-30.

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

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

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

Zhao J, Wang X, Zhang Q. Surgical treatment of comminuted intra-articular fractures of the distal humerus with double tension band osteosynthesis. Orthopedics. 2000;23(5):449-52.

Henley MB. Intra-articular distal humeral fractures in adults. Orthop Clin North Am. 1987;18(1):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, Schmit-Neuerburg KP, Sturmer KM, Walz M. Intra-articular fractures of the distal humerus. Surgical treatment and results. Clin Orthop. 1989;241:238-244.

McKee MD, Wilson TL, Winston L, Schemitsch EH, Richards RR. Functional outcome following surgical treatment of intra-articular distal humeral fractures through a posterior approach. J Bone Joint Surg Am. 2000;82(12):1701-7.

Pollock JW, Faber KJ, Athwal GS. Distal humerus fractures. Orthop Clin North Am. 2008;39(2):187-200.

Zagorski JB, Jennings JJ, Burkhalter WE, Uribe JW. Comminuted intra-articular fractures of the distal humeral condyles. Surgical vs. nonsurgical treatment. Clin Orthop Relat Res. 1986;202:197-204.

Holdsworth BJ, Mossad MM. Fractures of the adult distal humerus. Elbow function after internal fixation. J Bone Joint Surg Br. 1990;72(3):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(5):793-6.

Self J, Viegas SF, Buford WL, Patterson RM. A comparison of double-plate fixation methods for complex distal humerus fractures. J Shoulder Elbow Surg. 1995;4(1):10-6.

Stoffel K, Cunneen S, Morgan R, Nicholls R, Stachowiak G. Comparative Stability of Perpendicular Versus Parallel Double-Locking Plating Systems in Osteoporotic Comminuted Distal Humerus Fractures. J Orthop Res. 2008;26(6):778-84.

Ozer H, Solak S, Turanli S, Baltaci G, Colakoglu T, Bolukbasi S. Intercondylar fractures of the distal humerus treated with the triceps-reflecting anconeus pedicle approach. Arch Orthop Trauma Surg. 2005;125(7):469-74.

Fracture and dislocation compendium. Orthopedic trauma association committee for coding and classification. J Orthop Trauma. 1996;10(1):1-154.

Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and Reliability of the Mayo Elbow Performance Score. J Hand Surg Am. 2014;39(6):1146-50.

Erpelding JM, Mailander A, High R, Mormino MA, Fehringer EV. Outcomes following distal humerus fracture fixation with an extensor mechanism-on approach. The J Bone Joint Surg Am. 2012;94(6):548-53.

Dayanand BB, Vikrama E, Vell G. Functional outcome of surgical management of distal end humerus fracture in adults: a prospective study. International J of Orthopaedics Scien. 2019;5(4):692-97.

Githens M, Yao J, Sox AH, Bishop J. Open reduction and internal fixation versus total elbow arthroplasty for the treatment of distal humerus fracture: a systematic review and meta-analysis. J Orthop Trauma. 2014;28(8):481-8.

Downloads

Published

2020-04-22

How to Cite

Vashistha, D., Naik, S., Nandi, S., & Kulkarni, S. (2020). Clinical outcome of treatment of intra-articular distal humerus fracture with open reduction and internal fixation by orthogonal locking plate: a prospective study. International Journal of Research in Orthopaedics, 6(3), 471–476. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20201030

Issue

Section

Original Research Articles