Functional Outcome of Intra-articular Distal Humerus Fractures in Adults Treated with Bicolumnar Plating using Pre-contoured Distal Humerus Locking Plates: A Prospective Study
Volume 7 | Issue 1 | Jan – April 2019 | Page: 24-28 | Vinay B Patil, Anand Garampalli, S B Kamareddy, Amar.
Authors: Vinay B Patil , Anand Garampalli , S B Kamareddy , Amar .
 Department of Orthopedics, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India.
Address of Correspondence
Dr. Anand Garampalli,
Department of Orthopedics, M R Medical College, Kalaburagi, Karnataka, India.
Introduction: Distal humerus fractures in adults are relatively uncommon injuries amounting to 2–6% of all fractures and 30% of all elbow fractures. The complex shape of the elbow joint, the adjacent neurovascular structures make these fractures difficult to treat. The present study is undertaken to evaluate the functional outcome of intra-articular distal humerus fractures by open reduction and internal fixation using bicolumnar plating technique.
Materials and Methods: A total of 20 intra-articular distal humerus fractures were operated during December 2015–June 2017 were included in the study. All the patients were operated with pre-countered distal humerus locking plates in orthogonal fashion, and outcome was measured by MEPS, rate of union, rate of complications, and final range of motion. Results: In our series of 20 cases, there were 12 males and 8 females. 5 cases were due to self-fall, 14 were due to RTA, and one due to assault. Out of 20 cases, 4 (20%) were of C1 type of fractures, 14 (70%) were of C2, and 2 (10%) were of C3 type of fractures. Excellent results were seen in 12, good in 5, and fair in 3, according to MEPS. There were 2 cases of superficial infection and 2 cases of ulnar neuropathy, treated accordingly.
Conclusion: Operative treatment with stable anatomical internal fixation using anatomically pre-contoured distal humerus plates should be the line of treatment for all grades of intra-articular distal humerus fractures, as it gives best chance to achieve good elbow function.
Keywords: Intra-articular distal humerus fractures, ORIF, bicolumnar plating, MEPS.
1. Athwal GS. Distal Humerus Fractures. In: Rockwood And Green’s Fractures In Adults. Vol , 7’ Ed. Philadelphia: Lippincott Williams &
2. Watson – Jones R : Fractures and joint injuries,Vol.2 6th ed. : Churchill Livingstone, 1993, New Delhi
3. Kuntz Jr, David G, Baratz ME. Fractures of the elbow. OrthopClin North Am Jun1999;30(1):37- 61.
4. Jupiter JB, Neff U, Hoizach P, Ailgower M. Intercondylar fractures of the humerus. An operative approach. J Bone Joint SurgAm l985;672):2623S9
5. Athwal, George S, Rispoli, Damian M, Steinmann, Scott P. The anconeus flap transolecranon approach to the distal Humerus. Technical tricks. J Ortho
6. Campbell’s operative Orthopaedics,12th edition,2013
7. Sanchez-Sotelo J, Torchia ME, and O’DriscollSW : Complex distal humeral fractures : Internal fixation with a principle-based parallel plate technique. J Bone Joint Surg Am 2007;89(5);961-969
8. Reising K, Hauschild O, Strohm PC, SuedkampNP : Stabilisation of articular fractures of the distal humerus : early experience with a novel perpendicular plate system. 2009 Jun;40(6) : 611-7. doi : 10.1016/j.injury.2008.12.018. Epub 2009 Apr
9. Michael D. McKee, Tracy L. Wilson, Lucy Winston, Emil H. Schemitsch and Robin R. Richards. Functional Outcome Following Surgical Treatment of Intra-ArticularDistal Humeral Fractures Through a Posterior Approach. J Bone Joint Surg Am.2000;82-A (12):1701-1707.
10. Macko D, Szabo RM. Complications of tension band wiring of olecranon fractures. JBJS Am. 1985;67 : 1396- 401
11. Bryan RS, Morrey BF. Extensive posterior exposure of the elbow: A triceps-sparing approach. Clin OrthopRelat Res. 1982; 166:188-92
12. Rakesh Kumar Gupta,Vinay Gupta, Dickey Richard Marak. Locking plates in distal humerus fractures: study of 43 Patients, Chinese Journal of Traumatology,2013;16(4):207-211
13. Dr. Gurjinder Singh, Dr. HS Sohal, Dr. Rakesh Sharma, Dr.Jatin Banal and Dr. Jagdish Dhake. Outcome of precontoured locking plate fixation in distal humerus fractures, International Journal of Orthopaedics Sciences 2017; 3(1): 145-148
|How to Cite this article: Patil V B, Garampalli A, Kamareddy S B, Amar.Functional Outcome of Intraarticular Distal Humerus Fractures in Adults Treated with Bicolumnar Plating using Pre-contoured Distal Humerus Locking Plates: A Prospective Study. J Kar Orth Assoc. Jan-April 2019; 7(1): 24-28.
Leave a ReplyWant to join the discussion?
Feel free to contribute!