Functional outcome of locking anatomical plate in extra articular fracture of distal humerus

Abstract

Background: The complex anatomy of distal humerus with proximity of radial nerve makes the exposure and fixation of these fractures difficult. The standard technique of plate osteosynthesis considers to hold at least eight cortices in both distal and proximal ends. Following these principles becomes difficult in distal humerus fractures. These difficulties have been overcome with the use of anatomical extra-articular distal humerus plate which has more hole density in the distal part with 3.5 mm screws for greater hold in distal part. Methods: A prospective study was carried out at SMIMER Medical College and Hospital, Surat for 25 cases of distal third fracture excluding open fractures of patients between 18-60 years who attended our OPD or Emergency from June 2022 to November 2023.All patients were operated with the triceps-reflecting modified posterior approach. Regular clinical and radiological follow-up was done to evaluate functionality of elbow, union status of fracture, non-union, secondary displacement, implant failure and any complications. Results: Out of 25 patients, 6 had AO type A1 fracture, 14 patients had type B1 fractures and remaining 5 had type C1 fractures. Mean DASH score at final follow up was 18.3; range being 12.6 to 35.7 points. The mean elbow range of motion was 130 degrees (range: 120 to 140 degrees). The mean duration for complete radiological fracture union was 14 weeks, range being 10 to 18 weeks. Conclusion: The distal humerus extraarticular plate is choice of implant for the fixation of distal humerus fractures since it offers good stability of fracture and enables early return of functionality.