A prospective study to evaluate the functional outcome in intra-articular distal humerus fractures treated by dual plating

Abstract

Introduction: In adults, distal humerus fractures are uncommon and intra-articular, often involve both the medial and lateral columns1. Distal humerus fractures account for one-third of all elbow injuries. The fractures are usually complex, involve intra-articular surface, in our study Double plate fixation is considered the correct treatment for a comminuted intra-articular fracture of the distal humerus. The objective of this study was to evaluate the clinical outcome in intra articular distal humerus fractures treated surgically with dual plates.Material Methods: Prospective study was conducted in our hospital SRMS IMS Bhojipura Bareilly for a period of 18 months between November 2019 to April 2021. We studied 12 patients with distal humerus intercondylar fracture, included in study as per inclusion criteria treated surgically with dual plating. All the patients aged between 18 to 60 years.Results: Mean age of the patient was 41 +/- 13.39 years 7 cases were male and rest were female left sided involvement was more frequent in the present study 7 (58.3%) percent. 9 (75%) cases sustained fracture due to RTA followed by 3 cases due to fall from height According to AO classification, 13-C1, 13-C2 and 13-C3 fracture was reported among 41.7%, 41.7% and 16.7% of the subjects respectively. After 24 weeks of surgery, out of 5 subjects with 13-C1; good and excellent outcome was reported in 1 and 4 subjects respectively, while out of 5 subjects with 13-C2, good and excellent outcome was reported in 2 and 3 subjects respectively. All the subjects with 13-C3 fracture had fair outcome Out of total, 66.7% of subjects undergo open reduction and internal fixation of distal humerus with olecranon osteotomy whereas 33.3% subjects undergo surgery with para – tricepital approach After 24 weeks of surgery, out of 8 subjects with olecranon osteotomy; fair and excellent outcome was reported in 2 and 6 subjects respectively, while out of 4 subjects with para-tricepital approach; good and excellent outcome was found in 3 and 1 subjects respectively average duration of operative time was 117.35 +/- 4.93 minutes. Average duration of radiological union was 15 +- 2.83 week, outcome was calculated using Mayo elbow performance score (MEPS) showed excellent in 58.3%(7) good in 16.7% (2) and in 25% (3) with no poor outcome.Conclusion: Our study supports the use of dual locking plate fixation as an effective modality in treating intra-articular distal humeral fractures. It addresses the difficulties encountered while managing these fractures and provides a stable fixation with predictable and satisfactory results and an early return to function.