Acute compartment treatment results of distal humerał fractures

Abstract

In spite of the fact that distal humeral fractures constitute only 2% of all fractures, they are often the cause of significant elbow joint mobility restrictions, which may disturb proper functioning of the upper limb to a considerable extent. The aim of the study was to evaluate the results of distal humeral fractures treatment with particular focus on type-C fractures according to the AO/ASIF classification. The material of the study was composed of 60 patients between 25 and 82 years of age, treated in the Clinical Department of Orthopaedics and Traumatology of the University Hospital No. 1 in Bydgoszcz in the years 2009-2011. The patients were subject to operative treatment with the use of four techniques (ORIF – LCP-type plate, ORIF – AO-type plate, ORIF – AO screw(s), CRIF – K-wires). The average patient observation period was 18.7 months (±5.9). Patients under the study were subject to observation and functioning of the elbow joint was evaluated after surgery according to the MEPI score. Patients suffering from type-B fractures recorded better treatment results than those suffering from type-C fractures: p = 0.046. The differences between type A and types B and C have been statistically insignificant: p > 0.05. No impact of any type of fixation on the results of treatment has been recorded. In type-C group of fractures according to AO/ASIF, statistical analysis has shown advantage to the benefit of fixation with dedicated anatomical LCP plates and AO plates (p = 0.046). In this group, operative treatment using the aforesaid methods achieved good and excellent results (MEPI ≥ 75 points) in 81% of cases. Good treatment results depend on proper patient qualification for a particular surgical procedure and may be achieved also for type-C intra-articular fractures, provided that anatomical reduction of articular surface and stable plate osteosynthesis are obtained. In other types of distal humeral fractures (types A and B) similar treatment results may be obtained using different operative treatment techniques.