Functional outcome evaluation of distal humerus fracture fixation
Keywords:Distal humerus fractures, Locking plates and screws, Mayo’s elbow performance score, Non union
Background: Distal humerus fracture are complex, difficult to reduce and fix, cumbersome post-operative mobilization, and yet functional outcome is doubtful. Though various treatment modalities available for past many decades ranging from conservative management, K wire fixation to plate and screws, but still treatment remains difficult. The objective of the study was to assess functional outcome of operative fixation of distal humerus with locking plate and screws.
Methods: Prospective study was done in during November 2015 to June 2016 in Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. Patients with distal humerus fractures who were admitted into hospital for operative treatment after fulfilling inclusion and exclusion criteria were included into study. They were followed up to 6 months post-operatively. Functional outcome evaluation was done with Mayo’s elbow performance score.
Results: 30 patients were included into study with full data. We had excellent, good, fair and poor outcome in 17, 8, 3, 2 patients respectively. Except for infection in one, elbow stiffness in two and non-union in two patients, we had no other complications.
Conclusions: Management of distal humerus fractures with preoperative evaluation, pre-operative planning, use of locking plate and screws, early mobilization can result in good functional outcome.
Korner J, Lill H, Muller LP, Rommens PM, Schneider E, Linke B. The LCP-concept in the operative treatment of distal humerus fractures-biological, biomechanical and surgical aspects. Int J Care Injured. 2003;34(2):20-30.
Soon JL, Chan BK, Low CO. Surgical fixation of intra-articular fractures of the distal humerus in adults. Int J Care Injured. 2004;35(1):1383.
Mishra A, Singh V, Chaurasia A, PK. Lakhtakia operative management of intraarticular distal humeral fractures with locking plates. J Evolution Med Dent Sci. 2015;4(94):15923-6.
Singh V, Uikey S, Ganvir A, Ds M, Gaur S. Outcome analysis of intercondylar humers fractures treated by locking compression plates. Int J Med Res Rev. 2016;4(3):414-9.
Gupta RK, Gupta V, Marak DR. Locking plates in distal humerus fractures: study of 43 patients. Chin J Traumatol. 2013;16(4):207-11.
Atalar AC, Demirhan M, Salduz A, Kilicoglu O, Seyahi A. Functional results of the parallel-plate technique for complex distal humerus fractures. Acta Orthop Traumatol Turc. 2009;43(1):21-7.
Lakhey S, Sharma S, Pradhan RL, Pandey BK, Manandhar RR, Rijal KP. Osteosynthesis of intercondylar humerus fracture using Bryan and Morrey approach. J Nepal Med Assoc. 2010;49(2):129-32.
Li SH, Li ZH, Cai ZD, Zhu YC, Shi YZ, Liou J et al. Bilateral plate fixation for type C distal humerus fractures: experience at a single institution. Int Orthop. 2011;35(3):433-8.
Muzaffar N, Bhat K, Ahmad R, Wani R, Dar M. Functional results after osteosynthesis of distal humeral fractures with pre-contoured LCP system. Ortop Traumatol Rehabil. 2014;16(4):381-5.
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 Elb Surg. 2011;20(2):206-12.
Jung SW, Kang SH, Jeong M, Lim HS. Triangular fixation technique for bicolumn restoration in treatment of distal humerus intercondylar fracture. Clin Orthop Surg. 2016;8(1):9-18.