Evaluation of functional and radiological results of patients operated for distal humerus intraarticular AO/ASIF type C fractures

Aim: In current study, we aimed to present functional results of patient operated for intraarticular distal humerus fractures (AO/ASIF type 13-C1, 13-C2 AND 13-C3 fracture) and to determine factors that affect the functional results. Material and Method: Forty-seven patients operated for distal humerus fracture and followed at least six-months in Department of Orthopaedic and Traumatology, Inonu University Medicine Faculty between January 2009 and May 2020 were included the study. AO/ASIF type A and B fractures, patients younger than 18 year and followed less than 6 months were excluded. We retrospectively reviewed injury mechanism, fracture type, surgical technique, plate configuration and post-operatively starting time of elbow movements. Osteoarthritis and presence of heterotrophic ossification were evaluated with plain radiographs in last follow-up. Range of motion were also evaluated. Grip and pinch strengths were measured with dynamometer. The Quick Disability of Arm, Shoulder and Hand (Q-DASH) and Mayo elbow performance scores were used to evaluate functional results. Additionally, effects of age, gender, plate type, time from injury to surgical intervention, injury mechanism, fracture type, fracture of dominant or nondominant extremity and complication on functional results were investigated. Results: Twenty-nine of patients were male and 18 women with mean age of 43.7 years (18-92). Mean follow-up time was 73.2 months. Mean duration from injury to surgery was 6.1 days. Fifteen (31.9%) patients had open fracture and 18 patients (38.3%) had additional fractures concomitant to elbow fracture. Twenty-one of patients had concomitant diseases. Whereas mean post-operative splinting continuation and immobilization time was 5.1 weeks, time of patients initiating to physiotherapy was 7.2 weeks. In last follow-up, mean extension loss was 17.20 and mean flexion loss was 160 when compared to uninjured elbow. Mean range of motion was measured as 1200. Mean Q-DASH and Mayo scores were 15.1 and 88.4, respectively. Good and very good results were obtained in 91.5 of patients. Conclusion: Functional results of distal humerus fractures are generally good regardless of radiological results. Range of motion decreases significantly at fractured elbow. Fracture type, age, waiting time for surgery, duration of immobilization and presence of concomitant injury effects Q-DASH and Mayo scores. Complication rate increases as surgical time increased. In displaced fracture of distal humerus, to achieve functional results, anatomic reduction and stable internal fixation is the only treatment in most of patients