Intraarticular Fractures of the Distal Humerus

Total elbow replacement for complex fractures of the distal humerus

“…Our results do not imply that TER is necessarily the method of choice for such fractures, even in the older population. There are reports of good results after open reduction and internal fixation of these fractures in the elderly, [11][12][13][14][15] and if the surgeon feels that the fracture is amenable to stable fixation and early movement it is a good form of treatment. Most of these studies were in patients considerably younger than those in our series in which the only patient aged less than 81 years of age was a chronic alcoholic.…”

“…1,2,[7][8][9][10] Osteopenic bone, which is always present to some degree in the elderly population, predisposes to increased comminution and inadequate fixation. While some authors have reported good results in elderly patients [11][12][13][14][15] the same surgical techniques may also be less successful with a higher rate of complications. 7,16,17 Total elbow replacement (TER) is successful in patients with inflammatory arthritis, [18][19][20][21] and may be used in the treatment of post-traumatic osteoarthritis, although with less favourable results.…”

Postoperative complications of distal humeral fractures

“…Waddell et al (1988) had "complications of importance" in 7 out of 48 patients operated on mainly by a limited number of experienced surgeons. Letsch et al (1989) recorded loosening of implants in 5 and ulna nerve palsy in 6 out of 104 patients, but this study had a heterogeneous patient material and included also many unicondylar fractures in children. Compared with our study, the impression is that the complication rate found here was on no account lower than that reported in the previous studies.…”

A comparison of 90° and 180° plate constructions for cominuted distal humerus fractures in adults and effects on clinical results

“…Kırık kompleks hale geldikçe fonksiyonel sonuçların kötüleştiği bildirilmiştir. [6][7][8] Çift plak uygulamalarında plakların pozisyonuyla ilgili tartış-malar devam etmektedir. Bu açıdan, O'Driscoll parçalanmanın fazla olduğu, kemik kalitesinin kötü olduğu karmaşık kırıklarda sagital planda paralel 2 plak (medial ve lateral) kullanılması-nı ve 2.7 mm vidalar ile birbirini kilitleyecek tarzda, eklemi ilgilendiren parçalara daha fazla sayıda vida gönderilerek tespit yapılmasını önermektedir.…”

“…Başarılı sonuçları olan çalışılmaların tümünde erken rehabilitasyon üzerinde önemle durulmaktadır. [6,7,16] Ameliyat sonrası ikinci günden itibaren eklem hareketine başlanan ça-lışmalar vardır. [17,18] Çalışmamızdaki olgularda immobilizasyon, yapılan internal tespitin stabilitesi ve kırık parçalılığı dikkate alınarak yapıldı.…”