Functional Outcomes to Surgical Treatment of the Distal Humerus Intra-Articular Fractures in Adults

Background. The article deals with extra-articular fractures of the distal humerus, according to the АО/ASIF classification, which includes types 12A–C, depending on the plane of the fracture and the nature of the fragment displacement. The purpose was to study the features of the lower third humeral fractures and to conduct a comparative analysis of the outcomes of surgical treatment. Material and methods. One hundred and twenty-seven patients with extra-articular fractures of the distal humerus were under observation. For retrospective analysis, they were divided into a comparison group (n = 92) who underwent traditional bone osteosynthesis and a study group (n = 35) in whom a rod-type external fixation device developed by us was used. The short- and long-term functional results were studied using the Mayo Elbow Performance Score. Results. Various indicators, established by us for comparison, and treatment outcomes were analyzed in 101 patients (comparison group — 68 people, study group — 33). Many values of these parameters were quite comparable in terms of the age, gender, hospitalization terms, duration of surgeries, etc., but the revealed differences in indicators still did not reach the level of statistical reliability (p > 0.05). Evaluation of the clinical use of the device proposed by us showed restoration of the humeral anatomy, quite comparable to that in bone osteosynthesis, and the achievement of the final result of treatment. However, the number of complications by type and by total number was significantly higher (4.5 times; p ˂ 0.001) in the comparison group, where it accounted for the largest share of cases of neuropathies (16.18 %), nonunions (8.82 %), elbow contractures (8.82 %) and heterotopic ossification (4.42 %). The final score on the Mayo Elbow Performance Score in the comparison group was 84.9 ± 10.2 points, in the study group — 92.6 ± 3.7 points. At the same time, the total number of positive treatment outcomes after bone osteosynthesis was 66.18 %, after transosseous osteosynthesis — 81.82 %. Conclusions. The analysis of the data obtained allows us to recommend a method of minimally invasive osteosynthesis with a rod device of external controlled fixation as a method of choice for wider clinical use in the treatment of patients with lower third humeral fractures.

Download Full-text

Comparison of olecranon fixation techniques following transolecranon approach in intra-articular fractures of distal humerus in adult patients

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491719884944 ◽

2019 ◽

Vol 27 (1) ◽

pp. 33-39

Author(s):

Halil Ibrahim Ocalan ◽

Ozgun Karakus ◽

Gunhan Karakurum

Keyword(s):

Functional Outcomes ◽

Screw Fixation ◽

Distal Humerus ◽

Tension Band ◽

Cancellous Screw ◽

Articular Fractures ◽

Fixation Techniques ◽

Olecranon Fixation ◽

Technical Principles ◽

Tension Band Technique

Background: In this study, we assessed functional outcomes among olecranon fixation techniques used following transolecranon approach in patients with comminuted fracture of distal humerus. Methods: The study included 37 elbows that underwent olecranon osteotomy due to distal humerus fracture. Functional outcomes were assessed among patients who underwent fixation via tension band technique, plate, or screw fixation. Results: The implant irritation was seen in 18% of patients who underwent K-wire plus tension band fixation, in 75% of patients who underwent olecranon plate plus screw fixation, and in 18% of patients who underwent cancellous screw fixation. The rate for implant removal was 2.6 folds lower in K-wire plus tension band fixation when compared to olecranon plate plus screw fixation. Conclusion: We concluded that K-wire plus tension band technique and cancellous screw fixation performed in accordance with technical principles caused less skin problem when compared to other techniques. In olecranon fixation, both methods with enhanced stability by tension band can be preferred.

Download Full-text

The challenging surgical treatment of closed distal humerus fractures in elderly and octogenarian patients: radiographic and functional outcomes with a minimum follow-up of 24 months

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-017-2762-3 ◽

2017 ◽

Vol 137 (10) ◽

pp. 1371-1383 ◽

Cited By ~ 5

Author(s):

Carlo Biz ◽

Silvano Pierluigi Sperotto ◽

Nicola Maschio ◽

Matteo Borella ◽

Claudio Iacobellis ◽

...

Keyword(s):

Surgical Treatment ◽

Functional Outcomes ◽

Distal Humerus ◽

Humerus Fractures ◽

Distal Humerus Fractures

Download Full-text

What Are the Conditional Survival and Functional Outcomes After Surgical Treatment of 115 Patients With Sacral Chordoma?

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-016-4773-8 ◽

2016 ◽

Vol 475 (3) ◽

pp. 620-630 ◽

Cited By ~ 22

Author(s):

Tao Ji ◽

Wei Guo ◽

Rongli Yang ◽

Xiaodong Tang ◽

Yifei Wang ◽

...

Keyword(s):

Surgical Treatment ◽

Functional Outcomes ◽

Conditional Survival ◽

Sacral Chordoma

Download Full-text

Open reduction and internal fixation compared with primary total elbow arthroplasty for displaced intra-articular fractures of the distal humerus in the elderly

Current Orthopaedic Practice ◽

10.1097/bco.0b013e31823cd605 ◽

2012 ◽

Vol 23 (1) ◽

pp. 59-62 ◽

Cited By ~ 2

Author(s):

Cyril Mauffrey ◽

Njale Baraza ◽

Charlie Lewis ◽

David Seligson

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

The Elderly ◽

Distal Humerus ◽

Total Elbow Arthroplasty ◽

Elbow Arthroplasty ◽

Articular Fractures

Download Full-text

The effect of upper instrumented vertebra level (T9 vs T10) on radiologic and functional outcomes in the surgical treatment of adult spinal deformity in osteoporotic patients over 60 years of age

Brain and Spine ◽

10.1016/j.bas.2021.100134 ◽

2021 ◽

Vol 1 ◽

pp. 100134

Author(s):

Sina Coskun ◽

Sinan Kahraman ◽

Mustafa Eltayep ◽

Recep Dincer ◽

Ahmet Ates ◽

...

Keyword(s):

Surgical Treatment ◽

Spinal Deformity ◽

Functional Outcomes ◽

Adult Spinal Deformity ◽

Upper Instrumented Vertebra

Download Full-text

THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2010-0-3-144-151 ◽

2010 ◽

Vol 16 (3) ◽

pp. 96-102

Author(s):

V. V. Klyuchevsky ◽

Hassan Ben El Hafi

Keyword(s):

Soft Tissues ◽

Functional Results ◽

Distal Humerus ◽

Distal Segment ◽

Rigid Fixation ◽

Performance Score ◽

Mayo Elbow Performance Score ◽

Articular Fractures ◽

Active Mobilization ◽

Violent Acts

From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.

Download Full-text