INTRA-ARTICULAR FRACTURES OF DISTAL HUMERUS MANAGED WITH ANATOMIC PRE-CONTOURED PLATES VIA OLECRANON OSTEOTOMY APPROACH

Abstract

The treatment for displaced intra-articular fractures of the distal humerus is open reduction and internal fixation with early rehabilitation. Best exposure of both columns and articular surface of the distal humerus is achieved through olecranon osteotomy approach and fixation of two columns of distal humeruswith orthogonal plate construct which will allow absolute stability and early rehabilitation to restore early elbow joint function. 16 cases of intra-articular fractures of distal humerus were treated by open reduction and internal fixation (ORIF) with orthogonal plate construct via olecranon osteotomy approach. Chevron type olecranon osteotomy was performed and fixed with tension band wiring using 6mm CCS and SS wires in all cases. Radiological evaluationand regular clinical examination were done as per Mayo elbow Performance score. All fractures united within average duration of 3 months. More than 1000 range of motion is attained in 14 of cases. The mean Mayo Elbow Performance Score was 90.01 indicating excellent results. The factors for a successful outcome of intra-articular fractures of the distal humerus depends upon anatomic reduction, surgical technique, stable internal fixation, and early rehabilitation. ORIF with orthogonal plate construct securing both humeral columns via olecranon osteotomy approach results in excellent healing and functional outcomes.