The results of surgical treament for distal humerus fractures with articular involvements in adults

The Results Of Surgical Treament For Distal Humerus Fractures With Articular Involvements In AdultsObjectives: Distal Humerus fractures are usually displaced and involves articular surface thus requires surgical treatment. In this study the functional results of surgically treated distal humerus fractures were assessed.Material And Method: 28 patients treated for fractures of distal humerus between 1997?2008 were retrospectively reviewed. 17 (%61) patientswere male, 11 (%39) were female and mean age was 38,9(20?68). All fractures were AO type C. Of these fractures, 9 (% 31) were type C1 and 10(% 34) were type C2 and type C3 each. Etiologic causes of fractures were: gunshot injuries 2 (% 8), simple fall 8(% 27) ,fall from height 8 (% 27) ,motor vehicle accident 11 (% 38). 6 (% 21) fractures were open. Mean time to operation was 4,9 (0?14) days. The exposure was posterior in 25 (% 86) patients, lateral in one(% 3,5), medial in two (% 7), both lateral and medial in one (% 3,5) patient. The exposure included an olecranon osteotomy in 20(% 80), triceps splitting in 2 (% 8) and triceps sparing approach in 3 (% 12)patients. The method of fixation was vertically aligned double plates in 10 (% 35), paralel locking double plate in 6 (% 21) , single plate in 5 (%17) and screw-wire combination in 8 (% 28) patients.Results: Mean follow-up was 50,9 (6?132) months. All fractures except one healed. Mean elbow flexion was 111,5º (90º-135º), mean loss of extension was 21,8º (5º-60º). According to Mayo Elbow Performance Scorıng system, the results very good in 7 % 24), good in 15 (%52) , mean in 5 (% 17), and poor in 2 (% 7) paitents. Males, patients aged between 18 to 40, closed fractures, early surgery, transolecranon exposure, double plate fixation achieved better results.Conclusion: Anatomic reconstruction, rigid fixation and early rehabilitation improves the results of distal humeral fractures with articular involvement. Type of fracture and age of patient were found to be important factors.Keywords: Distal Humerus Fractures, internal fixation