A Novel Surgical Treatment Strategy for Fixation of Intra-articular Distal Humerus Fractures: Prospective Analysis of Functional Outcomes

Abstract

Context: Fractures in the distal humerus are complex and challenging injuries for orthopedic surgeons that can be effectively treated with open reduction and internal fixation. In literature, various surgical techniques and configuration of fixation have been described each with its own sets of advantages and disadvantages. AIMS: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation, i.e., lateral column plate with medial column screw (LCPMS). MATERIALS AND METHODS: This study was performed and the author’s personal experiences were reported. Thirty patients were treated using intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 (IBM, USA) was used for statistical analysis. Results: In our study, at the end of 6 months, overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. Majority of patients regained full arc of motion and achieved fracture union without any major complications and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusions: We concluded that our novel method of fixation of intra-articular distal humerus fractures (using lateral column plate and medial column screw–LCPMS) provides adequate stability and anatomical reconstruction with early union rate observed at the end of 6 months. Excellent and early improvement in functional outcomes was observed in almost all the patients and majority experienced very mild nature of pain in early postsurgery period which can be attributed to less operating time, less extensive dissection, and initiation of early physiotherapy protocol.

Keywords

• intra-articular distal humerus fracture
• lateral column plate
• percutaneous medial screw