Abstract
In young adults, most distal humerus fractures occur from high-energy trauma like Sidesweep injuries, motor vehicle accidents, falls from height and gunshot wounds. In elderly persons with more osteoporotic bone; most of these injuries occur from falls. Evolution of management of these fractures have revolutionized over time. Management of distal end of humerus fractures pose a challenge to treating orthopedic surgeon. Choice of implant depends of fracture anatomy and circumstances. In the present study we evaluate modes of management of distal end of humerus fractures in adults. Thirty six cases of fracture of distal humerus in adults were treated both conservatively and surgically and fixed using various implants in Mamata General Hospital, Khammam from October 2010 to October 2012. The Objectives of the study are to analyze the various methods of management of distal humeral fractures in adults. Most of the cases were males with age ranging between 18 to 65 years. By mayo elbow performance scoring system out of 36 patients, 14 patients (38.9%) had excellent results, 11 patients (30.6%) had good results, 4 patients (11.1%) had fair results and 7 patients (19.4%) had poor results. Reconstruction plates and cannulated cancellous screws offer excellent results in distal humeral fractures in adults.Open reduction and internal fixation with reconstruction plate and cancellous screws can be considered as the treatment of choice. With this method, proper length of the distal humerus, opposition, articular congruency, axial alignment, rotational alignment and stability with good range of motion of elbow can be restored. Hence, Reconstruction plates and cannulated cancellous screws can be considered as first line of management.
Highlights
We live in a society with a growing elderly population and a young population in which extreme sports and high speed motor transportation are popular, the incidence of distal humeral fractures is increased[1,2]
This series consists of 36 patients of fracture distal humerus treated by closed reduction / open reduction and internal fixation with K-wires, reconstruction plates and cannulated cancellous screws between October 2010 – October 2012 at Mamata General Hospital, Khammam
Out of all the above, 21 patients were treated by open reduction and internal fixation with reconstruction plates (3.5mm), cancellous screws, k wires and 9 patients were treated by closed reduction and internal fixation with k wires and 6 patients were treated conservatively by above elbow plaster of paris cast
Summary
We live in a society with a growing elderly population and a young population in which extreme sports and high speed motor transportation are popular, the incidence of distal humeral fractures is increased[1,2]. Most distal humerus fractures occur from high-energy trauma like Sidesweep injuries, motor vehicle accidents, falls from height and gunshot wounds. In elderly persons with more osteoporotic bone; most of these injuries occur from falls [3,4]. Improved understanding of the complex patho-anatomy of unstable distal humerus fractures in adults has prompted a global interest in more precise treatment for this diverse group of injuries [5,6]. Varying patterns of distal humeral fractures are common in adults. Even minor irregularities of the joint surface of the elbow usually cause some loss of function [9,10]
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