Distal Humerus Fracture Malunion in Adults: A Case Report and a Review of the Literature

Abstract

Introduction. Neglected distal humerus fractures are rare injuries, which the orthopaedic surgeon will not deal many times in his career. We present a case of a young patient with such an injury, who was treated with a corrective osteotomy and fixation, resulting in a very good outcome. This case report highlights the importance of surgical intervention for distal humerus fracture malunion. A narrative review of the literature regarding this topic is presented as well. Case Report. A 42-year-old female patient presented to our department nine weeks after a displaced distal humerus fracture, which was treated conservatively in another institution. Ulnar nerve neuropathy, pain, and severe stiffness of the elbow were her main symptoms. Open correction of the deformity, anatomical reduction of the articular surface, and realignment of the metaphyseal level of the fracture were performed. Six months postoperation, a painless flexion-extension arc of 110° and a normal rotation of the forearm was achieved. Conclusion. Distal humerus fracture malunion is a challenge. The operation needed for this purpose is much more demanding, and postsurgical complications are more likely to occur as opposed to the treatment of acute fractures. If a proper surgery is performed though, a good clinical outcome can be expected.