Distal Humerus Fractures
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Simranpreet Singh ◽  
Mudasser Arif ◽  
Sanjeev Gupta

Background: Distal humerus fractures are commonly encountered in the orthopedic emergency. The goals in the treatment of these fractures are aimed at perfect anatomical reduction which could be obtained by open reduction and internal fixation.Methods: A prospective cohort study was conducted from July 2019 to December 2020 in Government Medical College, Jammu on 35 patients with AO type C distal humerus fractures. Functional outcomes were recorded and evaluated at end of 6 months using mayo elbow performance score (MEPS) score. 3 patients were lost in the follow up and were not included in the study.Results: 32 patients in the age group 20-65 years were included in the study with a mean age of 42.5 years. Males outnumbered females in ratio of 3:1. Patients undergoing olecranon osteotomy for fixation of distal humerus fractures had mean elbow flexion (121±8.3), loss of elbow extension (10.3±4.2). The functional outcome was made using MEPS score with a mean of 84±8.4 at final follow up.Conclusions: In this study we concluded that olecranon osteotomy approach provided better outcome. Intraarticular distal humerus fractures was better visualized with olecranon osteotomy approach and allowed early mobilization.

Petro Bilinskyi

Treatment of distal humerus fractures is a complex problem in traumatology. The result of treatment depends on the choice of fixator according to the fracture area. Objective. To improve the techno­logy of treatment in patients with complicated distal humerus fractures with fixators of small contact and multiplanar osteosynthesis and to evaluate its efficacy. Methods. 39 patients were treated for the period 2000–2020 with distal humerus nonunion (types 12-B1, 12-C1, 12-C2) and 23 patients with complicated above- and transcondylar humerus fractures (types 13-A2, 13-C1, 13-C2). Fixation of bone fragments of the distal humerus was made with device for fixation (Patent 17502 UA). It is a shaped plate with a groove on which half rings with threaded holes are stabilized. For the osteosynthesis of above- and transcondylar humerus fractures we used V-shaped plate with the possibility to regulate branch spreading width as for the condylar size (Patent 33358 UA). Autografting was performed as for necessity. Results. Plate osteosynthesis was performed mainly through anterior approach with minimal tissues traumatization. Release of radial nerve we made as for necessity. This device provides the stable fixation even in a case of short distal fragment. Device for bone fragments fixation was placed on the posterior condylar surface and lower part of the humerus through olecranon osteotomy. Osteosynthesis with suggested device is one of the options with bone autografting and can be method of choice at repeated surgery. Follow-up period was 1–2 years and later. In 60 patients we obtained good results with completed bone union. Conclusions. Suggested device can be used in cases of distal humerus nonunion. It allows to decrease the damage of surgery, to avoid many complications. Key words. Complicated fractures of the distal humerus, devices for limited-contact multiplanar osteosynthesis.

Injury ◽  
2021 ◽  
Cole M. Patrick ◽  
Joshua C. Tadlock ◽  
Leon J. Nesti ◽  
John C. Dunn ◽  
Nata Parnes

2021 ◽  
Vol 35 (5) ◽  
pp. S11-S15
Ryan Mayer ◽  
Andrew Choo ◽  
David Zuelzer

Ahmadreza Zarifian ◽  
Ali Akbarinezhad Fough ◽  
Denise Eygendaal ◽  
Michael Rivlin ◽  
Seyed Ali Mousavi Shaegh ◽  

J. Ryan Taylor ◽  
Kelsey E. Shea ◽  
Charles F. Clark ◽  
James D. Kelly ◽  
Mark A. Schrumpf

2021 ◽  
pp. 491-497
Brandon Girardi ◽  
Emil H. Schemitsch ◽  
Aaron Nauth

2021 ◽  
Vol 6 (1) ◽  
pp. 1336-1340
Santosh Thapa ◽  
Ranjib Kumar Jha ◽  
Ashish Rajthala

Introduction: Owing to the complex articular structure, paucity of metaphyseal bone and thin soft tissue covering, treatment of intra-articular distal humerus fractures still pose challenge to surgeons. Although it comprises 2% of all fractures the massive complication rate to the treatment is worrisome. This study aims to evaluate the outcome of surgical treatment of these fractures by open reduction and internal fixation by dual orthogonal plates. Objectives: The objective of the study is to evaluate the functional outcome of intercondylar humerus fractures managed with open reduction and internal fixation with orthogonal dual plating technique. Methodology: Eighteen patients (19 – 68 years old) with AO/OTA type 13C fractures were evaluated after surgery for one year with MEPS and range of motion. Complications were categorized as major or minor complications. Functional comparisons were made between simple articular type C1/C2 and complex articular type C3 fractures at one year. Result: There were 2 (11.11%) type C1 fracture and 8 (44.44%) each in type C2 and C3 fractures. Eight (44.44%) patients obtained excellent, 7 (38.89%) obtained good and 3 (16.7%) obtained fair results. There was no poor outcome. Average MEPS score was 83.33 and there was no significant between the subgroups (p = 0.07). The average flexion was 118.06° and it was significantly impaired in type C3 fractures (p = 0.03). Three patients obtained full extension, and remaining patients had mean extension deficit of 12°. Average arch of motion was 108.06° with significant difference between two subgroups (p = 0.008). The mean arc of motion for supination-pronation was 154.44°. There was 5 minor and 2 major complications (total - 38.9%). Conclusion: The surgical management with open reduction and internal fixation by dual plates in orthogonal configuration for the intercondylar distal humeral AO type C fractures has good or excellent functional outcome in majority of the patients.

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