A prospective study of surgical management of distal end humerus fractures in adults

Author(s): Dayanand BB, Santosh S Nandi, Tapan S Gupta, Amit Patel

Abstract: Introduction: Distal humerus fractures are uncommon injuries that account for fewer than 2% of all adult fractures. The aim of the study is to evaluate the functional outcome of the surgical management of distal humerus fractures in adults treated by various methods using the post-operative functional criteria by Riseborough and Radin and the Mayo Elbow Performance Index (MEPI). Materials and Method: A Prospective clinical study was conducted over a period of 4 years which included 93 patients in tertiary care centre. The patients were treated with primary open reduction and internal fixation using 3.5 mm reconstruction plates, 4 mm cannulated cancellous screws, bipillar plating using reconstruction plating, K-wires and Y plate or a combination of the above methods using a posterior approach. Results: The average age of the patients in our study was 42.91 years with a range of 18-72 years. In our series, according the Riseborough and Radin criteria, the results were Good in 55(59.13%) patients, Fair in 32(34.4%) and Poor in 6(6.45%) patients. According to MEPI, we had Excellent results in 20(21.5%), Good in 43(46.2%), Fair in 25(26.8%) and Poor in 5(5.37%) patients. Conclusion: Operative treatment with rigid anatomical internal fixation should be the first line of treatment for all grades of Riseborough Radin intercondylar fractures, more so in young adults as it gives best chance to achieve good elbow function. Vigorous, active physiotherapy is a must for good results. Stable fixation allows early, active and aggressive post-operative mobilization.

DOI: https://doi.org/10.22271/ortho.2016.v2.i4d.36