Abstract
Objective To summarize our experience of treating distal humeral fractures of AO/OTA type C with parallel-plate fixation in the aged. Methods From January 2007 to September 2008, we treated 22 cases of type C distal humeral fractures by parallel-plating. They were 6 males and 16 females, with a mean age of 70. 2 (range, 60 to 81 ) years, including 3 open fractures (Gustilo type Ⅰ) and 19 close fractures. According to AO classification, there were 5 cases of type C1, 10 cases of type C2 and 7 cases of type C3. The posterior midline approach was selected. After the articular surface of the distal humerus was exposed through the olecranon osteotomy or the liguliform flap of triceps brachii muscle, parallel-plate fixation was performed to fix fractures internally. All patients began functional exercise of the elbow joint from 3 days after operation. Results All patients were followed up for a mean of 18 (range, 13 to 35) months. All fractures achieved complete union. The mean degrees of the elbow movement were as follows: extension was 16°(range, 0 to 50°), flexion 125° (range, 95° to 140°), supination 65° (range, 40° to 90°) and pronation 67°(range, 40° to 90°). According to Mayo elbow performance score (MEPS), 11 cases were graded as excellent, 8 as good, 2 as fair and one as poor. 86. 4% of the patients had an excellent or good functional result. Two cases reported transient ulnar nerve paralysis, 2 heterotopic ossification, one delayed union and elbow stiffness,3 slight symptoms of traumatic arthritis, and 2 slight malformation of cubitus varus. Conclusions Parallel-plate fixation is a preferred treatment for AO type C distal humeral fractures in the aged because of satisfactory bone healing, early mobilization and recovery of joint function. However, more attention should be paid to the complexity of the fracture which may influence the therapeutic effects of the operation. Key words: Humeral fracture; Elbow joint; Fracture fixation, internal; Aged
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