Indian Journal of Orthopaedics Surgery


A STUDY ON FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF INTRA ARTICULAR FRACTURES OF DISTAL HUMERUS IN ADULTS


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Author Details: Ramesh Krishna. K, Aradhana. T. R, Preetham. N

Volume : 1

Issue : 1

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 57

Article End Page : 59


Abstract

Background: Intra-articular distal humerus fractures comprise 1% of all fractures in adults1. Recent studies have emphasised the importance of surgical approach, rigid fixation and early rehabilitation for good outcome.
Objectives: To assess the anatomical reduction of distal humeral articular surface by radiological examination and stability of the elbow by the functional assessment over a period of 1 year. Methodology: Thirty consecutive patients with distal humerus fractures were treated from October 2012 to October 2014 .The fractures were fixed using AO double column (orthogonal) plating techniques. Physiotherapy started from 3rd day post-op. Patients were followed at 6weeks, 3 months, 6 months, 1 year interval. Clinical outcome assessed using MEPI (Mayo Elbow Performance Index) score and radiologically assessed for reduction, alignment, fracture union, and complications.
Results: All patients had completed postoperative physical therapy at the time of the study and had achieved maximum function of elbow. The mean duration of follow-up was 12 months. The mean arc of flexion was 106°. Mean pronation was 76° and supination was 77°. The mean MEPI score was 95.1 points (range 0 to 100 points), indicating mild impairment. Radiographic evidence of fracture union was noted in all patients.
Conclusion: We conclude that internal fixation of intra-articular fractures of the distal humerus is an effective procedure with an excellent functional outcome in most patients. Patients have a high level of satisfaction and the majority return to their previous level of activity.

Key Words: Intra-articular distal humerus fracture; olecranon osteotomy; triceps reflecting approach; orthogonal plating; MEPI