Study of outcome of distal humerus fracture treated with plating

Abstract

Background and Aim: Bicondylar intraarticular fractures of the distal humerus, because of their rarity and often associated significant displacement, comminution, and osteopenia, present the orthopaedician with a difficult injury to treat successfully. But modern techniques of open reduction and internal fixation provide stable construct to allow early post-operative motion without compromising bone healing. The aim of the present study is to evaluate the functional outcome of surgical management of the distal humerus with extra and intraarticular extension in adults using plating.Material and Method: A total of 20 patients were included in the study. All the included patients had fractures of the distal humerus, aged >18 during the period of 2020-2021 in our hospital. Fracture is classified according to AO-OTA Classification. All are treated by open reduction and plating. Length and type of plate were selected as per fracture pattern. Post-Operatively above elbow cast was given to decrease pain and edema. The patients are followed up at regular intervals of 4,8,12 and 16 weeks and results were evaluated using the Mayo Elbow Performance Score for the results of treatment.Results: We had 25% excellent, 50% good results, 10% fair & 15% poor results.Discussion and Conclusion: Open reduction internal fixation should be done as early as possible. Delay in open reduction internal fixation with delayed soft tissue dissection leads to increased chances of elbow stiffness due to periarticular fibrosis. For a successful internal fixation of the closed distal humeral fracture, it is necessary to maintain anatomic and stable reconstruction of the articular surface and of both humeral columns using two 90-90° plates. Operative treatment with rigid anatomical internal fixation should be the line of treatment for all grades of extra and Intercondylar fractures, more so in young adults, as it gives the best chance to achieve good elbow function.