Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2010 Apr;23(2):201-205. Korean.
    Published online Apr 30, 2010.
    https://doi.org/10.12671/jkfs.2010.23.2.201
    Copyright © 2010 The Korean Fracture Society
    Original Article

    Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture

    Myung Jin Lee, M.D., Hyeon Jun Kim, M.D., Sung Keun Sohn, M.D., Kyu Yeol Lee, M.D., Sung Soo Kim, M.D., Chul Hong Kim, M.D., Lib Wang, M.D. and Hyun Woo Sung, M.D.
      • Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.
    • Address reprint requests to: Hyeon Jun Kim, M.D. Department of Orthopedic Surgery, Dong-A University College of Medicine, 1, Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. Tel: 82-51-240-5167, Fax: 82-51-254-6757, Email: campbellkim@naver.com
    Received August 19, 2009; Revised March 09, 2010; Accepted March 24, 2010.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    To evaluate functions of the elbow joint according to surgical approach, time to exercise, and type of fracture after surgical treatment for the intra-articular comminuted fracture of the distal humerus.

    Materials and Methods

    27 patients with the intra-articular comminuted fractures of the distal humerus underwent surgery from March, 2000 to January, 2007. We investigated the surgical approach, time for union, time to exercise and age. We also evaluated postoperative functions of the elbow joint according to the flexion contracture, the range of motion and the Mayo elbow performance score.

    Results

    The average follow-up period was 37 months and the average time for union was 14 weeks. The average range of flexion was 115 degrees, the average flexion contracture was 10 degrees, and the Mayo elbow performance score with average value of 85 point showed good clinical results. There were no statistically significant differences in functions of the elbow joint according to the operative method and age. However, patients with early postoperative exercise within 6 days showed statistically better outcomes than patients with postoperative exercise after 7 days. Type C1, 2 fractures showed statistically better results than the type C3 fracture.

    Conclusion

    Stable fixation and early exercise are required to prevent postoperative complications and restore functions of the elbow joint with an intra-articular comminuted fracture of the distal humerus.

    Keywords
    Distal humerus; Intra-articular fracture; Surgical treatment

    Figures

    Fig. 1
    42-year-old female sustained the distal humerus fracture.

    (A) Preoperative radiographs show the comminuted intra-articular fracture of the distal humerus (AO classification type C3).

    (B) Postoperative radiographs show stable fixation. A reconstruction plate and headless screw were fixated through transolecranon approach.

    (C) At follow-up of 12 months, a reconstruction plate was removed.

    Tables

    Table 1
    The relationship between surgical approach and postoperative functions of the elbow joint

    Table 2
    The relationship between age and postoperative functions of the elbow joint

    Table 3
    The relationship between fracture type and postoperative functions of the elbow joint

    Table 4
    The relationship between time to exercise and postoperative functions of the elbow joint

    References

      1. Aitken GK, Rorabeck CH. Distal humeral fracture in the adult. Clin Orthop Relat Res 1986;(207):191–197.
      1. Aslam N. Surgical fixation of intra-articular fractures of the distal humerus in adults. Injury 2005;36:804–805.
      1. Bryan RS, Morrey BF. Extensive posterior exposure of the elbow. A tricepssparing approach. Clin Orthop Relat Res 1982;166:188–192.
      1. Helfet DL, Schmeling GJ. Bicondylar intraarticular fractures of the distal humerus in adults. Clin Orthop Relat Res 1993;292:26–36.
      1. Houben PF, Bongers KJ, Wildenberg FA. Double tension band osteosynthesis in supra- and transcondylar humeral fractures. Injury 1994;25:305–309.
      1. Husband JB, Hastings H 2nd. The lateral approach for operative release of posttraumatic contracture of the elbow. J Bone Joint Surg Am 1990;72:1353–1358.
      1. Jupiter JB. Complex fractures of the distal part of the humerus and associated complications. J Bone Joint Surg Am 1994;76:1252–1264.
      1. Kang SY, Lee HJ, Chung JW. Modified lateral approach to the distal humerus fractures. J Korean Orthop Assoc 2000;35:705–710.
      1. Korner J, Lill H, Muller LP, et al. Distal humerus fractures in elderly patients: results after open reduction and internal fixation. Osteoporos Int 2005;16 Suppl 2:S73–S79.
      1. Lee HJ, Kang SY, Kang KS, Lee SH, Kim CH. Surgical treatment of intercondylar fracture of the distal humerus through the modified triceps sparing approach. J Korean Orthop Assoc 2003;38:584–587.
      1. McKee MD, Wilson TL, Winston L, Schemitsch EH, Richards RR. Functional outcome following surgical treatment of intra-articular distal humeral fractures through a posterior approach. J Bone Joint Surg Am 2000;82-A:1701–1707.
      1. Morrey BF. Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J Bone Joint Surg Am 1990;72:601–618.
      1. O'Driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg 2005;14 1 Suppl S:186S–194S.
      1. O'Driscoll SW. The triceps-reflecting anconeus pedicle (TRAP) approach for distal humeral fractures and nonunions. Orthop Clin North Am 2000;31:91–101.
      1. Pollock JW, Athwal GS, Steinmann SP. Surgical exposures for distal humerus fractures: a review. Clin Anat 2008;21:757–768.
      1. Rah SK, Kim SK, Choi JG, Kim YI, Choi CU. Comparison between transolecranon approach and posterior approach in comminuted intercondylar fracture of the distal humerus. J Korean Soc Fract 1996;9:1069–1075.
      1. Ring D, Jupiter JB. Complex fractures of the distal humerus and their complications. J Shoulder Elbow Surg 1999;8:85–97.
      1. Ring D, Jupiter JB. Fractures of the distal humerus. Orthop Clin North Am 2000;31:103–113.
      1. Soon JL, Chan BK, Low CO. Surgical fixation of intra-articular fractures of the distal humerus in adults. Injury 2004;35:44–54.
      1. Tyllianakis M, Panagopoulos A, Papadopoulos AX, Kaisidis A, Zouboulis P. Functional evaluation of comminuted intra-articular fractures of the distal humerus (AO type C). Long term results in twenty-six patients. Acta Orthop Belg 2004;70:123–130.
      1. Wang KC, Shin HN, Hsu KY, Shih CH. Intercondylar fracture of the distal humerus. Routine anterior subcutaneous transpositon of the ulnar nerve in posterior operative approach. J Trauma 1994;36:770–773.
      1. Werner CML, Ramseier LE, Trentz O, Heinzelmann M. Distal humeral fractures of the adult. Euro J Trauma 2006;32:264–270.
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    MeSH Terms
    Contracture
    Elbow
    Elbow Joint
    Follow-Up Studies
    Fractures, Comminuted
    Humans
    Humerus
    Intra-Articular Fractures
    Postoperative Complications
    Range of Motion, Articular
    Metrics
    Share
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