Functional outcome of distal humerus fracture in adults followed with bicolumnar fixation: A prospective study

Abstract

Background: Distal humerus Fractures account for about 0.5 - 2% of all adult fractures, out of which a significant percentage (50 - 70%) of patients present with intraarticular and intercondylar involvement; thereby posing operative challenges to the surgeon. An attempt has been made in this study to evaluate the radiological and functional outcome of distal humerus fractures treated with bi columnar fixation. Materials and Methods: Our study consists of 20 posts traumatic distal humerus fracture AO type C operated at Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram between May 2019 and December 2021. The Mayo Elbow Performance Score was employed for the assessment of Functional Outcome. Patients were regularly followed up at the intervals of 6 weeks, 3 months, 6months and 1 year postoperatively. Results: There were 13 (65.0%) female patients, and 7 (35%) male patients over a wide age range of 18 years to 75 years. The mean age of these patients being 44.6 years. The majority had an involvement of the nondominant limb; left humerus 15 (75%) and the rest of the cases were right humerus 5 (25%). The fractures were stabilized with bicolumnar locking compression plates with Lag Screws depending on the fracture pattern. The final follow-up majority showed good to excellent outcomes with the mean arc of elbow flexion of 116 degrees, average extension deficit of 7 degrees, average supination of 70 degrees, and average pronation of 70 degrees. Conclusions: Olecranon Osteotomy approach gave a better visualization of the fracture site and an easier articular reconstruction opportunity. Bicolumnar fixation showed good outcomes and achieved satisfactory union rates.