Ali Engin Ulusal1, Unal Boz, Zeki Sertöz, R Gür Ustaoğlu. 1. Department of Orthopedics and Traumatology (2. Ortopedi ve Travmatoloji Kliniği), Izmir Atatürk Training and Research Hospital, Izmir, Turkey. aeulusal@yahoo.com
Abstract
OBJECTIVES: We compared the results of surgical techniques used in the treatment of distal humeral fractures. METHODS: The study included 22 patients (15 men, 7 women; mean age 52 years; range 21 to 80 years) who were treated for closed distal humeral fractures. The fractures were classified according to the Müller's classification (18 type 3, 4 type 4) and Mehne-Matta's classification of intraarticular fractures. Following open reduction, internal fixation was performed with the use of double reconstructive plates in seven patients (32%), multiple K-wires in eight patients (36%), and multiple screws in seven patients (32%). The mean follow-up period was 42 months (range 24 to 72 months). The results were assessed using the Mayo Elbow Performance Scoring system. RESULTS: The results were very good in five patients (22.7%), good in eight patients (36.4%), fair in five patients, and poor in four patients (18.2%). Valgus and varus deformities were found in six (27.3%) and three (13.6%) patients, respectively, and 12 patients (54.6%) had decreased muscle strength. Two patients (9.1%) in the K-wire group developed instability due to insufficient union. Heterotopic ossification was detected in five patients (22.7%). None of the patients had persistent or severe pain. Two patients (9.1%) were free of pain, while 11 patients (50%) had occasional and mild pain, and nine patients (40.9%) had moderate pain on activity. The mean Mayo Elbow Performance scores were 88, 72, and 55 with plate, screw, and K-wire applications, respectively. CONCLUSION: It was concluded that open reduction followed by internal fixation with double reconstructive plates was superior to K-wire and screw fixations in the treatment of distal humeral fractures.
OBJECTIVES: We compared the results of surgical techniques used in the treatment of distal humeral fractures. METHODS: The study included 22 patients (15 men, 7 women; mean age 52 years; range 21 to 80 years) who were treated for closed distal humeral fractures. The fractures were classified according to the Müller's classification (18 type 3, 4 type 4) and Mehne-Matta's classification of intraarticular fractures. Following open reduction, internal fixation was performed with the use of double reconstructive plates in seven patients (32%), multiple K-wires in eight patients (36%), and multiple screws in seven patients (32%). The mean follow-up period was 42 months (range 24 to 72 months). The results were assessed using the Mayo Elbow Performance Scoring system. RESULTS: The results were very good in five patients (22.7%), good in eight patients (36.4%), fair in five patients, and poor in four patients (18.2%). Valgus and varus deformities were found in six (27.3%) and three (13.6%) patients, respectively, and 12 patients (54.6%) had decreased muscle strength. Two patients (9.1%) in the K-wire group developed instability due to insufficient union. Heterotopic ossification was detected in five patients (22.7%). None of the patients had persistent or severe pain. Two patients (9.1%) were free of pain, while 11 patients (50%) had occasional and mild pain, and nine patients (40.9%) had moderate pain on activity. The mean Mayo Elbow Performance scores were 88, 72, and 55 with plate, screw, and K-wire applications, respectively. CONCLUSION: It was concluded that open reduction followed by internal fixation with double reconstructive plates was superior to K-wire and screw fixations in the treatment of distal humeral fractures.