Vol. 10, Issue 4 (2024)
Management and outcome of distal humerus TY condylar fracture by 90/90 distal humerus locking plate
Md. Ibrahim Miah, Mohammed Ramzanul Karim Khan, Moyeen Ahmed Ferdous, Md. Alinoor, Md. Motiur Rahaman, Sharif Md. Musa, AKM Latiful Bari, Md Shafiqul Alam, Jamal Uddin Ahmed, Mohammad Faroque Eastiak, Ahsan Majid, Mahamud Mannan and Mohammad Moshiur Rahman
Background: Distal humerus TY condylar fractures present a significant challenge in orthopedic trauma. This study evaluates the efficacy of the 90/90 distal humerus locking nail system in the management of these complex fractures.
Methods: A prospective study of 50 patients (28 males, 22 females; mean age 47.3 years) with distal humerus TY condylar fractures treated using the 90/90 distal humerus locking nail system was conducted. Patients were followed for a mean of 18.7 months. Outcomes were assessed using the Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH) score, range of motion, and radiographic union. Complications were recorded.
Results: All fractures achieved union with a mean time to union of 14.2 weeks. The mean MEPS improved from 32.6 preoperatively to 86.3 at final follow-up (p<0.001). The mean DASH score decreased from 68.5 to 18.2 (p<0.001). At final follow-up, 84% of patients had excellent or good results according to MEPS criteria. The mean flexion-extension arc was 110.6°. Complications occurred in 7 patients (14%), including transient ulnar nerve neuropraxia (6%), superficial infection (4%), and heterotopic ossification (4%). No implant failures or loss of reduction were observed.
Conclusion: The 90/90 distal humerus locking nail system demonstrates high union rates, significant functional improvement, and an acceptable complication profile in the treatment of TY condylar fractures of the distal humerus. This technique provides stable fixation allowing for early mobilization and favorable functional outcomes.
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