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

Abstract

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 and evaluate the intermediate term results (minimum follow up of two years) of communited intra-articular distal humerus fractures treated with bicolumnar plating with or without olecranon osteotomy in elderly Indian population. Methods: This is a prospective type of study of 20 cases of supracondylar fracture humerus with inter condylar extension treated surgically with dual plating which were admitted to Jaya Aarogya Hospital & Trauma Center, Gwalior, Madhya Pradesh, between 2015 to 2016. All the patients of supra condylar fracture distal humerus with age between 18 to 60 years with medical fitness for surgery were included in the study. Results: The mean age of the patient was 40±2 years, 12(60%) cases were males, and 8(40%) cases were females. Right sided involvement was more frequent in the present study 13(65%) cases. 14(70%) cases sustained fracture due to road traffic accident, 06(30%) cases had a domestic fall. The average duration of surgery was 94±10 mins. The average duration of the radiological union was 14±06 weeks in 12(60%) cases, 15±04 weeks in 5 (25%) cases, 19±05 weeks in 3 (15%) cases. The outcome was calculated using the ASES and DASH scores. The American shoulder and elbow surgeons score showed excellent in 5 (25%) good in 11 (55%) fair in 4(20%) and no poor outcome. Conclusions: For good functional results, precise preoperative planning, adequate surgical approach, anatomical inter fragmentary stabilization, medial-post erolateral plating, and early post-operative physiotherapy help in restoring painless and functional elbow for distal humeral intra-articular fractures. This step-by-step approach results in satisfactory functional results.