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

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.

scholarly journals Functional outcome of the treatment of AO-ASIF type C distal humerus fracture using Lambda plate

2020 ◽  
Vol 13 (2) ◽  
pp. 128-133
Author(s):  
Krishna Bahadur Bista ◽  
Rabeendra Prasad Shrestha ◽  
Bhola Shrestha ◽  
Ishwar Sharma Kandel ◽  
Rabi Mohan Dakal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
P Value ◽  
Fracture Treatment ◽  
Distal Humerus Fracture ◽  
Number Of Patients ◽  
Type C

Introduction: Although the use of two plates for the treatment of type-C distal humerus fracture is popular, site of plate placement still is under debate. Use of Lambda plate for the fracture treatment can be easier and settle the dispute. This study aims to evaluate the functional outcome of the surgery using Lambda Plate. This can be a reference for surgeons and helps them make the decision about choice of implant for type C distal humerus fracture treatment among Nepalese people. Methods: This interventional study used Lambda plate for the treatment of type C fracture of distal humerus. Patients were examined at 4, 12, and 24 weeks respectively for the measurement of the outcome. Visual analogous scale was used for assessment of pain, range of motion for functional recovery and Mayo Elbow Performance Score was used for the assessment of functional outcome. Paired-samples t-test and linear regression was used to for data analysis. Results: Functional outcome at the last follow-up was excellent in 24(53.33%) patients, good in 18(40%) patients and fair in 3(6.67%) patients. Range of motion of elbow increased significantly with every follow-up (p-value <0.001). Average angle of flexion at last follow-up was 117.53°±11.74 while loss of extension was 7.53°±4.86. Average number of patients had their fracture union at 19.84±2.38 weeks. There was no association of age, sex and union weeks with functional outcome when measured with MEPS. Conclusion: Fixation of distal humerus fracture by using Lambda plate gave excellent and satisfying outcome in terms of pain, range of motion and objective functional outcome.  

scholarly journals Total Elbow Arthroplasty Gives Good Functional Outcome in Distal Humerus Fracture with Pre-existing Chronic Elbow Dislocation

2018 ◽  
Vol 24 (1) ◽  
pp. 60-65
Author(s):  
Chan Hing Shing ◽  
Ho Sheung Tung
Keyword(s):  
Internal Fixation ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Total Elbow Arthroplasty ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Elbow Arthroplasty ◽  
Flexion Extension ◽  
Long Stem ◽  
Chronic Elbow Dislocation

Distal humerus fracture with concomitant chronic elbow dislocation is difficult to manage by open reduction and internal fixation, while total elbow arthroplasty (TEA) is an effective treatment for acute fracture or failed internal fixation of distal humerus fracture in elderly patients with osteoporosis. We present a case of an 86-year-old woman who suffered from acute distal humerus fracture in the presence of chronic elbow deformity from elbow dislocation since childhood at the age of 10 years. This was treated with TEA using Coonrad/Morrey prosthesis with long stem and long flange humerus components and cerclage wiring of humeral condyle. Postoperatively, elbow mobilization was started early within a hinged elbow brace. There was no operative complication. At the last follow-up 22 months after surgery, there was no pain and good elbow motion (20–130° flexion–extension arc, full supination and pronation to neutral) was obtained. The Mayo Elbow Performance Score was 100. There was incorporation of the bone graft at the anterior flange with no radiographic loosening of the prosthesis. This case shows that TEA can yield a gratifying clinical result and efficiently resolves two problems with one solution.

scholarly journals SURGICAL MANAGEMENT OF COMPOUND DISTAL HUMERUS FRACTURE BY JESS EXTERNAL FIXATOR

2014 ◽  
Vol 3 (19) ◽  
pp. 5352-5366
Author(s):  
Utkal Gupta ◽  
Sanjay Gupta ◽  
Gaurav Aggrawal ◽  
Arjun Gandotra ◽  
Pathania V P
Keyword(s):  
Surgical Management ◽  
External Fixator ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Distal Humerus Fracture

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

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.

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p><p class="abstract"> </p>

scholarly journals A study of functional outcome after osteosynthesis of intercondylar fracture of distal humerus in adults with pre-contoured locking compression plate system

2019 ◽  
Vol 5 (6) ◽  
pp. 1107
Author(s):  
Ankur Ojha ◽  
Shashi Kant Kumar Singh
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
High Rate ◽  
Humerus Fracture ◽  
Time Interval ◽  
Distal Humerus Fracture ◽  
Ulnar Nerve Palsy ◽  
Dual Plating ◽  
Plate System

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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).<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

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