Tratamiento de las fracturas diafisarias extraarticulares de húmero distal por abordaje posterior modificado y placa extraarticular

Abstract

PurposeTo evaluate the clinical and radiological outcomes of these fractures treated through a modified posterior approach with a distal humerus plate. Material and methodsBetween 2013 and 2015 we performed a retrospective study of these fractures surgically treated in our centre. Inclusion criteria: older than 18 years old, no pathological fractures, follow up 1 year at least. 23 patients underwent surgery, mean age 45 years old, with an average follow-up of 18 months.Patient characteristics, aetiology and type of fractures were recorded. The surgery was performed using Gerwin modified posterior approach with a posterolateral distal humerus plate. Clinical results were evaluated using Quick DASH, MEPS, VAS. Radiological results were also evaluated. Complications associated with treatment and radial nerve palsy incidence were recorded as well. ResultsType of fracture according AO/OTA: six 12-A, seven 12-B, ten 12-C. 23 patients progressed to union.After one year: QD 6.43, VAS 0.66, MEPS 88.88. No failure of internal fixation. Two superficial infections. 15 excellent results, 5 good, and 3 fair, with no poor results. ConclusionSurgical fixation of these fractures through a modified posterior approach with a posterolateral plate minimises iatrogenic nerve injury, provides better visualisation of the proximal humerus, provides stable fixation of these injuries and results in high union rates and overall excellent functional results.