A prospective study of functional outcome in intra articular distal humerus fracture treated with dual plating

Background: Intra-articular fracture of distal humerus is considerable cause of morbidity in adults. The new pre-contoured LCP system provides better angular stability in fixation of inter-condylar distal humerus fracture.Methods: A prospective study of 25 patients with distal humerus fracture treated with pre-contoured double plate system is conducted in Department of Orthopaedics, RIMS, Ranchi between April 2017 to March 2018. These patients were followed up 3 weekly in first 3 months, then 6 weekly in next 6 months, then at every 3 month interval. Clinical and functional outcome was evaluated on the basis of Mayo elbow performance score (MEPS).Results: 24 fixed elbows were reviewed at a follow-up period of 1 year. Results obtained were graded on the basis of MEPS, 21 patients (87.5%) were graded excellent to good, fair in 2 patients (8.3%) and poor in 1 case (4.1%). Average time interval between surgery and admission was 9 days (average 4-14 days). All the fractures as well as the olecranon osteotomies united by 10-16 weeks (12.56 weeks). Superficial wound infection and transient ulnar nerve palsy was reported in 3 (12.5%) and 1 (4.16%) respectively and was managed conservatively. 1 patients did not reported in follow up.Conclusions: We conclude that osteosynthesis with pre contoured dual plating of closed intracondylar distal humerus fractures provide good fixation and early rehabilitation, leading to high rate of bone union and minimal soft tissue damage.

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STUDY OF THE FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERUS FRACTURE (AO/OTA TYPE C) IN ADULTS

10.36106/ijsr/0809423 ◽

2020 ◽

pp. 1-3

Author(s):

Ravindra Prasad ◽

L B Manjhi

Keyword(s):

Internal Fixation ◽

Range Of Motion ◽

Functional Outcome ◽

Surgical Management ◽

Distal Humerus ◽

Humerus Fracture ◽

Joint Surface ◽

Distal Humerus Fracture ◽

Complex Anatomy ◽

Type C

Introduction: Distal humerus fracture in adults particularly complete articular (AO/OTA Type C) remain some of the most difficult injuries to manage. Complex anatomy of distal humerus combined with multifragmented fracture, sparse soft tissue cover with adjacent neurovascular structures poses great difficulty for treatment. Goal of treatment is to obtain a painless, stable and mobile elbow joint through a systematic approach. Aim: to study the functional outcome of surgical management of complete articular distal humerus fracture in adults. Method: a prospective study comprising of 20 patients treated surgically with open reduction and internal fixation using Orthogonal plating (dorsolateral and medial 3.5mm LCP) through trans olecranon approach. Result: Mean age of patients was 36.6 years (range 19 to 58 years) with male dominance, most fractures were of type 13C1 (AO/OTA). RTA accounts for most common mode of injury, majority of them being left sided. Mean operative time was 130 minutes. Complications included one case of superficial infection, 3 cases of ulnar neuropathy and non-union in 2 cases. Mean range of motion of elbow was 89 degree. Functional outcome assessed using Mayo Elbow Performance Score (MEPS) shown Excellent result in 12 cases, good to fair results in 6 and poor result in 2 cases. Conclusion: Anatomical restoration of joint surface and rigid internal fixation with bicolumnar orthogonal plating allowing early range of motion is the key for obtaining good functional results in complete articular distal humerus fractures. However, outcomes do deteriorate with increasing fracture complexity.

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Prospective study of distal humerus fracture fixation with an extensor mechanism on approach

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i1h.73 ◽

2017 ◽

Vol 3 (1h) ◽

pp. 506-508

Author(s):

Dr. Rakesh Tirkey ◽

Dr. Jitendra Jamdar ◽

Dr. Rajiv Savant

Keyword(s):

Prospective Study ◽

Fracture Fixation ◽

Distal Humerus ◽

Extensor Mechanism ◽

Humerus Fracture ◽

Distal Humerus Fracture

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A PROSPECTIVE FOLLOW UP STUDY OF FUNCTIONAL OUTCOME OF SUPRACONDYLAR HUMERUS FRACTURE WITH INTERCONDYLAR EXTENSION TREATED WITH OLECRANON OSTEOTOMY APPROACH

10.36106/gjra/8702726 ◽

2021 ◽

pp. 76-79

Author(s):

Pradeep Choudhary ◽

Mahesh Bhati ◽

Ramniwas Bishnoi ◽

Aditya Srimal ◽

Jayesh Chouhan

Keyword(s):

Functional Outcome ◽

Distal Humerus ◽

Humerus Fracture ◽

Distal Humerus Fracture ◽

Range Of Movement ◽

Mayo Elbow Performance Score ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

Frequent Presence

Introduction- Olecranon osteotomy is standard approach for low transcondylar and intercondylar distal humerus fractures. Distal humerus fractures are difcult to manage successfully because of the local anatomic constraints, the frequent presence of comminution,displacement and osteopenia. We studied the functional outcome and complications following surgical xation using this approach. Material And Methods- A total 20 consecutive patients(male:15,female:5),having mean age 42.1yrs, of Distal Humerus fractures who will attend the casualty or O.P.D during the thesis period(June2018 to October2020) at Mahatma Gandhi Hospital & Mathuradas Mathur Hospital Jodhpur (Rajasthan) will be included in study group and managed surgically using olecranon osteotomy approach. Functional outcome was evaluated using the Mayo Elbow Performance Score(MEPS) and complications were observed. Results- Mean loss of extension was 10°.Mean exion achieved was 122.75°.Mean range of movement at treated elbow was 113°. All fractures united by the end of 3 months. Final results were excellent in 8 cases; good in 7 cases; fair in 4 and poor in one case. Most common complication in our study was discomfort due to hardware(6 cases). Supercial infection occurred in 2 cases. Screw/wire backout occurred in 2 cases. Elbow stiffness and malunion happened in one case. Functional outcome was also dependant on fracture subtype. Conclusion- Intraarticular distal humerus fracture treated with olecranon osteotomy approach had good articular exposure and surgical xation. This approach had good functional outcome and fewer complications.

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Functional outcome of elbow joint in AO type 13C fractures treated with open reduction and internal fixation using dual plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191793 ◽

2019 ◽

Vol 5 (3) ◽

pp. 509

Author(s):

Uyyalawada Sreedhar Reddy ◽

Bheemsingh Samorekar ◽

Vinay J. Mathew ◽

Anil Kumar Mettu

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Distal Humerus ◽

Range Of Movement ◽

Excellent Outcome ◽

Significant Difference ◽

Dual Plating ◽

Type C ◽

A Prospective Study

Background: Distal end of the humerus, with its unique orientation of articular surfaces supported by a meagre amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons. Aim of the study is to evaluate the functional outcome of surgical management of intercondylar AO type C fractures of distal end of humerus using dual plating.Methods: A prospective study was conducted at our hospital between January 2015 to December 2016. Thirty five consecutive patients with intercondylar (AO Type C) fracture of distal humerus, included in study as per inclusion criteria. All patients were treated surgically using triceps reflecting approach and posterior trans-olecranon approach with ulnar nerve exploration and fixation using dual plating and tension band wiring for olecranon osteotomy wherever done.Results: In 35 patients, final results using MEPS scoring system excellent outcome is noticed in 15 patients (42.86%), good results is noticed in 13 patients (37.14%), fair result is noticed in 5 patients (14.29%) and poor result is noticed in 2 patients (5.71%). There was statistical significant difference in flexion range of movement arc at 2 and 6 months in our study.Conclusions: Open reduction and internal fixation of AO type 13C fractures is challenge to surgeon, preoperative planning and mastering the technique over a period of time gives good to excellent functional outcomes.

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