scholarly journals Challenges and Solutions in Management of Distal Humerus Fractures

2017 ◽  
Vol 11 (1) ◽  
pp. 1292-1307 ◽  
Author(s):  
Saif Ul Islam ◽  
Alexander William Glover ◽  
Mohammad Waseem

Background:Management of distal humerus fractures remains a challenge for trauma surgeons and advancements in treatment options continue to be made to achieve the best results for patients presenting with these complex fractures. Our aim in this article is to provide the surgeons with a detailed review of current literature to help them make an evidence based decision when faced with managing such complex injuries in their surgical practice.Methods:This is a comprehensive review of the current literature that details various aspects of distal distal humerus fractures such as classification, surgical anatomy, surgical approaches, treatment options, choices of devices, outcomes and complications.Results:With the advancements in techniques and equipment, there has been improvement in patients’ outcomes following surgical management of these fractures and a large proportion of these patients are able to achieve pre-injury level of function. The contoured locking plates have enabled successful fixation of many of these fractures that were previously considered unfixable. For those not amenable to surgical fixation, total elbow arthroplasty and elbow hemiarthroplasty are considered as good alternatives.Conclusion:Since the days where the ‘bag of bones’ technique was the preferred method of treating these complex injuries, techniques and outcomes have advanced greatly. However, they still present a significant technical challenge and need meticulous technique and experience to achieve optimal results.

Author(s):  
Riyaz B. Shaik ◽  
Venugopala Reddy P. ◽  
Ashok Naidu K.

Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating.Methods: This is a prospective type of study of 20 cases of supra condylar fracture humerus with inter condylar extension treated surgically with dual plating one on the medial boarder and another on posterior surface of lateral column using standard dorsal approach, olecranon osteotomy.Results: The range of age was between 18-52 years, with mean age of 32.55 years. The maximum incidence was between 18 to 40 years i.e. 16 cases (80%). With road traffic accident (RTA) as major cause of injury. Most   of the patients were males 14 (70%) with right upper limb was involved in 12 (60%) cases. According   to MEP score clinical outcome was excellent in 4(20%) good in 10(50%) fair in 5(25%) and poor in one (10%).Conclusions: Distal humerus fractures are known for their complex nature and technical difficult in surgical management. Proper anatomical articular reconstruction and stable fixation helps in restoring painless and functional elbow.


2014 ◽  
Vol 23 (2) ◽  
pp. 251-257 ◽  
Author(s):  
John A. Scolaro ◽  
Pramod Voleti ◽  
Amun Makani ◽  
Surena Namdari ◽  
Amer Mirza ◽  
...  

2016 ◽  
Vol 30 (5) ◽  
pp. 245-250 ◽  
Author(s):  
Arvind Von Keudell ◽  
Amir R. Kachooei ◽  
Ali Moradi ◽  
Jesse B. Jupiter

2017 ◽  
Vol 11 (1) ◽  
pp. 1353-1363 ◽  
Author(s):  
James C. Beazley ◽  
Njalalle Baraza ◽  
Robert Jordan ◽  
Chetan S. Modi

Background:Distal humerus fractures constitute 2% of all fractures in the adult population. Although historically, these injuries have been treated non-operatively, advances in implant design and surgical technique have led to improved outcomes following operative fixation.Methods:A literature search was performed and the authors’ personal experiences are reported.Results:This review has discussed the anatomy, classifications, treatment options and surgical techniques in relation to the management of distal humeral fractures. In addition, we have discussed controversial areas including the choice of surgical approach, plate orientation, transposition of the ulnar nerve and the role of elbow arthroplasty.Conclusion:Distal humeral fractures are complex injuries that require a careful planned approach, when considering surgical fixation, to restore anatomy and achieve good functional outcomes.


2019 ◽  
Vol 13 (1) ◽  
pp. 18-19
Author(s):  
Eduardo Garcia-Rey ◽  
Eduardo Garcia-Cimbrelo

Author(s):  
Ravi Kumar ◽  
Ajay Karwasra ◽  
Kishore Kunal

<p class="abstract"><strong>Background:</strong> Fractures of the adult distal humerus account for approximately 2% of all fractures and represent a third of all humerus  fractures. Fractures of the distal third of the humerus are challenging injuries due to their peri-articular location, small size of the distal bone fragments, and the osteopenic quality of the bone in older adults.  Aim of our study was to evaluate the clinical, radiographic and functional outcomes of posterolateral locking compression plate for extra-articular distal third humerus fractures through posterior triceps splitting approach.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done at All India Institute of Medical Sciences, Patna  in which 30 consecutive skeletally mature, closed extra-articular distal humerus fractures  underwent fixation with posterolateral  locking compression plate and outcome evaluated in terms of radiological  evidence of healing, functional outcome and complications if any.<strong></strong></p><p class="abstract"><strong>Results:</strong> Use of posterolateral plate results in predictably good union rates and excellent results terms of patient outcome without any implant related complications.</p><p class="abstract"><strong>Conclusions:</strong> We recommend using this posterolateral plate for these humerus fractures, because of its consistent results with respect to fracture union, stability across the fracture site and early mobilization for better functional results.</p>


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