BACKGROUND: An intra-articular distal humerus malunion can be disabling. To improve function, reduce pain and/or prevent further secondary osteoarthritis an intra-articular corrective osteotomy can be considered. Herein we present the indications, practical guidelines for pre- operative planning and surgical technique. Subsequently, we provide long-term results in a small series. METHODS: We included six consecutive patients operated for intra-articular distal humerus malunion. Mean follow-up was 88 months. At lastest follow up elbow function was assessed according to standardized questionnaires and classification systems. RESULTS: All six patients healed their osteotomies. Three patients had a postoperative complication which were treated succesfully. Range of motion improved significantly and all patients were satisfied with the outcome. The elbow performance scores were good to excellent in all. Correlation analyses showed that age and level of osteoarthritis are very strong predictors for the long-term elbow function and quality of life. CONCLUSION: An intra-articular corrective osteotomy for a malunited distal humerus fracture is a worthwhile procedure. Based on our results it should particularly be considered in young patients with minimal osteoarthritis and moderate to severe functional disability and/or pain.
BACKGROUND: An intra-articular distal humerus malunion can be disabling. To improve function, reduce pain and/or prevent further secondary osteoarthritis an intra-articular corrective osteotomy can be considered. Herein we present the indications, practical guidelines for pre- operative planning and surgical technique. Subsequently, we provide long-term results in a small series. METHODS: We included six consecutive patients operated for intra-articular distal humerus malunion. Mean follow-up was 88 months. At lastest follow up elbow function was assessed according to standardized questionnaires and classification systems. RESULTS: All six patients healed their osteotomies. Three patients had a postoperative complication which were treated succesfully. Range of motion improved significantly and all patients were satisfied with the outcome. The elbow performance scores were good to excellent in all. Correlation analyses showed that age and level of osteoarthritis are very strong predictors for the long-term elbow function and quality of life. CONCLUSION: An intra-articular corrective osteotomy for a malunited distal humerus fracture is a worthwhile procedure. Based on our results it should particularly be considered in young patients with minimal osteoarthritis and moderate to severe functional disability and/or pain.
Authors: G J King; R R Richards; J D Zuckerman; R Blasier; C Dillman; R J Friedman; G M Gartsman; J P Iannotti; J P Murnahan; V C Mow; S L Woo Journal: J Shoulder Elbow Surg Date: 1999 Jul-Aug Impact factor: 3.019
Authors: Aaron Nauth; Michael D McKee; Bill Ristevski; Jeremy Hall; Emil H Schemitsch Journal: J Bone Joint Surg Am Date: 2011-04-06 Impact factor: 5.284
Authors: L Obert; M Ferrier; A Jacquot; P Mansat; F Sirveaux; P Clavert; J-L Charissoux; L Pidhorz; T Fabre Journal: Orthop Traumatol Surg Res Date: 2013-10-30 Impact factor: 2.256
Authors: Ioannis M Stavrakakis; Zisis Ntontis; Olga Kastritsi; Constantinos Chaniotakis; Kalliopi Alpantaki; Grigorios Kastanis Journal: Case Rep Orthop Date: 2022-04-29