Management of lower humeral intercondylar fractures in adults with different implants

Abstract

We reviewed the results of internal fixation with various types of implants in a series of 20 patients (mean age, 33.6 years; range, 21-58 years) with type C intraarticular fractures of the distal humerus after a mean follow-up of 7 months (range, 6-9 months;). We used olecranon osteotomy for better visualisation of articular fragments. When stability of the humeral columns is achieved and the articular platform is reconstructed, satisfactory results can be obtained, even in comminuted fractures. Early postoperative mobilisation was advised to prevent elbow stiffness. Excellent results were observed in 10 (50%), good in 5(25%), fair in 3(15%) and poor in 2(10%) cases, according to the rating system of the Cassebaum. All patients treated with open reduction and internal fixation with recon/locking plating had an excellent or good result, whereas 2 cases with poor result was due to open fracture and are fixed with external fixation in one case and the other with k-wires, both these cases had elbow stiffness and superficial infection. In summary, the concept of open reduction and internal fixation of intercondylar fractures of the humerus with dual plates is very valuable, in restoring articular surface and early rehabilitation decreasing morbidity, resulting good results.