Study on surgical management of distal humerus fractures in adults treated with bicolumnar plating

Abstract

Background & Objectives: Distal humerus fractures in adults comprise 2% of all fractures and 30% of all humeral fractures. Intra-articular distal humerus fractures account for 37% and involve both medial and lateral columns. Most of the distal humeral fractures in adults must be treated surgically to get better functional outcome. The aim of this study was to assess the efficacy, technical requirements, functional outcome, radiological and clinical union, and complications of distal humerus fractures treated with bicolumnar plating. Aims and Objectives: The Aim of the present study is to evaluate the Functional Outcome of Surgical Management of distal Humerus fractures by Open Reduction and Internal using bicolumnar plating technique. Materials and Methods: A total of 30 distal humerus fractures admitted in teaching and general hospital were operated included in the study. Patients fitting in to inclusion criteria were selected. All the patients were operated with ORIF with precountered locking distal humerus plates in orthogonal fashion and outcome was measured by MEPS, rate of union, rate of complications and final range of motion. Results: In our series of 3 0 cases, there were 22 males and 8 females with average of 36.8 years. 17 cases were due to direct fall, 10 due to road traffic accident and 3 due to direct assault. There was a predominance of left side (24). Out of 30 cases, 6 (20%) were of 13C1 type, 21(70%) were of 13C2 type and 3 (10%) were of 13C3. Excellent results in 21, good in 6 and fair in 3 cases, according to MEPS. There were 3 (10%) cases each of superficial infection and 3 (10%) cases of ulnar neuropathy, treated accordingly. There were no cases of non-union, implant failure or heterotopic ossification. Conclusion: Operative treatment with rigid anatomical internal fixation, should be the line of treatment for fractures of distal humerus, as it gives best chance to achieve goodelbow function. During open reduction and internal fixation, anatomic reconstruction of articular surface should be given prime importance. Stable fixation allows early active and aggressive postoperative mobilization.