A PROSPECTIVE STUDY ON FUNCTIONAL OUTCOME OF DISTAL HUMERUS FRACTURE TREATED BY ORTHOGONAL PLATING

Abstract

The distal humeral fractures, especially the comminuted intra articular, remain one of the most challenging injuries to treat. Various problems in distal humerus fracture management include frequent articular involvement, metaphyseal comminution, bone loss and osteopenia. The study analysed the functional outcome of twenty patients of distal humeral fractures treated surgically with orthogonal plating with average follow up of 13months (6 months – 2 ½ years). The good anatomical alignment, absolute stabilization and early mobilization were of prime importance in elbow fractures. Subjects of this prospective study were 20 consecutive patients based on the exclusion and inclusion criteria. All patients underwent ORIF with orthogonal plating through Olecranon osteotomy (Chevron) approach. The patients were followed up periodically based on the MEPS (Mayo Elbow Performance Score) and radiological outcome were analysed. The Mean age of the patients was 45 years ranging from 20 to 65 years.AO type C3 fractures constituted 50% while C2 fractures constituted 45%And C1 fractures constituted only 5% of our cases. In our study, the average surgical time delay was 6 days ranging from 5 to 20 days. Two patients had infection. None of them had ulnar nerve damage post operatively. Stiffness was noted in 2 patients. No patient died during treatment or follow up. The average time to union was about 14 weeks. There was no hardware failure or non-union in any patient. The mean exion-extension arc was 96°. The mean MEPS score was 78 in our study. Of the 20 patients, 9(45%) patients had Excellent, 5(25%) patients had good, 4(20%)patients had fair, 2(10%)patients had poor nal outcome. We conclude that with good anatomical reduction with a stable internal xation, preserving the blood supply to the bone along with protection of the ulnar nerve and early elbow mobilization ensure the good functional outcome and early return to activities