Functional and radiological outcomes of distal humerus fractures treated with pre-contoured locking compression plate
Keywords:Distal humerus, Pre contoured plates, Olecranon osteotomy
Background: Distal humerus intra-articular fractures are one of the complicated fractures managed by orthopaedic surgeons. We did a prospective and a retrospective study on 21 patients with these fractures treated with pre-contoured locking compression plate.
Methods: The 21 patients in this series were followed for a minimum of 1 year. The prospective study cases were followed at 3 months, 6 months and annually. The rating system of the Mayo elbow functional scoring system was used. The radiological evaluation was done using standard AP and lateral views.
Results: We had 14 patients with range of motion of 50-100 degrees. There was only one patient with range of motion of <50 degrees. 6 patients had the maximum range motion of >100 degrees. We had 6 (23.57%) excellent, 9 (42.85%) good, 5 (23.80%) fair and 1 (4.7%) poor in the Mayo elbow scoring at the end of 1 year. We were able to compare our outcomes with a study done by Kumar et al done in 2017. They had 27 (89.66%) of excellent and good results as opposed to 27 (79.4%) in our study. Out of 21 patients in our study 17(80.95%) patients had good 11 (52.5%) / excellent 6 (28.5%) results. This was comparable with Jupiter et al. His study of 34 patients 26 (79.40/0) patients showed good 14 (41%) / excellent 13 (38.4%) result.
Conclusions: Pre-contoured locking compression plate appears to be technically an ideal implant for comminuted osteoporotic bone providing an angle stable construct.
Amir S, Jannis S, Daniel R. Distal humerus fractures: a review of current therapy concepts. Curr Rev Musculoskelet Med. 2016;9(2):199-206.
Kong L, Wang Y, Lu Q, Han Y, Wang F. Biomechanical properties of a novel fixation system for intra-articular distal humerus fractures: a finite element analysis. J Orthop Surg Res. 2021;16(1):674.
Wennergren D, Stjernström S, Möller M, Sundfeldt M, Ekholm C. Validity of humerus fracture classification in the Swedish fracture register. BMC Musculoskelet Disord. 2017;18(1):251.
Ebraheim NA, Andreshak TG, Yeasting RA, Saunders RC, Jackson WT. Posterior extensile approach to the elbow joint and distal humerus. Orthop Rev. 1993;22(5):578-82.
Kumar G, Rani S, Kumar R. Outcome of management ofdistal humerus fractures by locking compression plate. Int J Orthopedic Sci. 2017;3(3):757-64.
Jupiter JB, Nef1 D, Holzach P, Allgower M. Intercondylar fractures of the humerus. An operative approach. J Bone Joint Surge Am. 1985;67-A(2):226-39.
Doornberg JN, Van Duijn PJ, Linzel D Surgical treatment of intra-articular fractures of the distal part of the humerus. Functional outcome after twelve to thirty years. J Bone Joint Surg Am. 2007;89(7):1524-32.
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.
Mckee MD, Wilson TL, Winston L. Functional outcome following surgical treatment of intra-articular distal humerus fractures through a posterior approach. J Bone Joint Surg Am. 2000;82-A(12);1701-7.
Helfet DL, Hotchkiss RN. Intenal fixation of the distal humerus: a biomechanical comparison of methods. J Orthop Trauma. 1990;4(3):260-4.