Study of clinical outcome in intra articular distal humerus fractures treated with dual plating

Abstract

Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating.Methods: This is a prospective type of study of 20 cases of supra condylar fracture humerus with inter condylar extension treated surgically with dual plating one on the medial boarder and another on posterior surface of lateral column using standard dorsal approach, olecranon osteotomy.Results: The range of age was between 18-52 years, with mean age of 32.55 years. The maximum incidence was between 18 to 40 years i.e. 16 cases (80%). With road traffic accident (RTA) as major cause of injury. Most of the patients were males 14 (70%) with right upper limb was involved in 12 (60%) cases. According to MEP score clinical outcome was excellent in 4(20%) good in 10(50%) fair in 5(25%) and poor in one (10%).Conclusions: Distal humerus fractures are known for their complex nature and technical difficult in surgical management. Proper anatomical articular reconstruction and stable fixation helps in restoring painless and functional elbow.

A prospective study of functional outcome in intra articular distal humerus fracture treated with dual plating

“…Newer, minimally invasive, percutaneously inserted bridge plates also have been described and have been used to avoid extensive dissection and potential nerve injury [9,10] . In our study, we treated all 20 cases with open reduction and internal fixation with dual plating in 90-90 configuration i. e. one plate on medial boarder and another on posterior surface of lateral column, were 12(60%) males and 8(40%) females comparable to study by Shaik RB et al [1] and in Wang et al [11] studies showed 60% males and 40% females. In which 14 cases (70%) were due to road traffic accident (RTA) and 6 cases (30%) were due to direct fall injury comparable to Henley et al [11] study showed 61% cases due to RTA and 39% cases due to direct injury.…”

“…Distal humerus fractures make up 0.5 to 2% of all fractures, but up to 30% of fractures involving the elbow [1] . In adults, most distal humerus fractures are intra-articular and involve both the medial and lateral columns [1] .…”

“…In adults, most distal humerus fractures are intra-articular and involve both the medial and lateral columns [1] . There have been variable reports as regards to functional outcome of open reduction and internal fixation of these fractures.…”

“…The Orthopaedic Trauma Association's alpha-numeric system 3, assigned three main types: Type A (extra-articular), Type B (partial articular), and Type C (complete articular). The OTA system's clinical application is limited and is hindered by poor inter-observer reliability beyond identification of the basic three types [1] . Different types of implants like K wires, 4mm cancellous screws, 3.5mm recon plates and one third tubular plates are used during operative procedure.…”

Operative Management of Intra-Articular Fractures of Distal Humerus in Adult

“…Two (2) patients (10%) had Gustilo type I (all males, one with gunshot and one after road traffic accident). Posterior Campbell's approach was used in fourteen (14) patients (70%) and Trans-olecranon approach was done in Six (6) patients (30%). In Six (6) type C I patients (30%) fractures Osteosynthesis were achieved by Inter-condylar Malleolar screws, one-third tubular plate and reconstruction plate.…”