Functional and radiological outcome in distal third humerus fracture treated with extra-articular locking plate: A multicentric retrospective study

Abstract

Introduction: The optimal method for fixation of extra-articular distal humerus fractures poses a management dilemma. Although various plate configurations have been proposed, anatomic shaped extra-articular distal humerus locking plates (EADHPs) have emerged as a viable solution for these complex injuries. We assessed functional and radiologic outcomes in our retrospective case series of extra-articular distal humerus fractures managed with these plates at different centers in Cuttack, Odisha. Materials and Methods: One hundred and ten patients of extra-articular distal humerus fractures, who were operated at various trauma centers between January 2012 and December 2020, were identified. After exclusion, 100 patients were available for the final assessment. All patients were operated with the triceps-reflecting modified posterior approach. Regular functional–radiologic follow-up was done evaluating elbow functionality, fracture union, secondary displacement, nonunion, implant failure, and any complications; Mayo Elbow Performance Score (MEPS) was used for the final functional assessment. Results: Sixty-seven percent of male and 33% of female patients constituted the study group, who had an average follow-up of 18 months. Preoperatively three patients and postoperatively one patient had radial nerve palsy; all had neurapraxia and recovered completely. Overall, 95% of patients were adjudged to have complete radiological union within 3 months; 6% of patients developed nonunion. The mean flexion achieved was 123 + 22, and the mean extension was 4.031 + 6.50; five patients with head injury developed flexion deformity of 45. The average MEPS at the final follow-up was 91 + 9.8. Conclusion: Stable reconstruction and early initiation of physiotherapy are utilitarian to envision optimal outcome; the use of precontoured EADHPs has yielded satisfactory results with minimal complications in our hands.

Keywords

• distal humerus
• extra-articular
• fracture
• locking plate
• outcome