Online ISSN: 2515-8260

Keywords : Distal Humerus Fracture

Functional outcomes of dual plating of distal humerus fractures with triceps tongue method

Dr Abhishek Garg, Dr Anand Gupta, Dr Sirshendu Roy, Dr Rahul Sharma, Dr Manmeet Malik, Dr Puneet Yadav, Dr Gaurav Kumar Agrawal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1567-1573

Background: Fixation of intra-articular distal humerus fractures has remained a
challenge to orthopaedic surgeons due to complicated anatomy of elbow, comminution
at fracture site and osteopenia of articular surfaces. We aimed to evaluate the functional
outcomes and complications after dual plating for distal humerus fractures with triceps
tongue technique. Materials and Methods: We conducted a retrospective study which
consisted of 20 cases of distal humerus fracture with intraarticular extension and
treated with open reduction and internal fixation with dual column plating using triceps
tongue technique. Triceps Tongue approach allows exposure of distal humerus articular
surface by forming an inverted V-shaped flap of distal triceps at the musculotendinous
junction. Results: Union was achieved in all cases. Mean time of fracture union was
14.65±1.82 weeks. There was no case of non-union although elbow stiffness occurred in
one patient. The mean MEPS score was 83.45±9.18 with a range of 70-95. Conclusion:
Triceps Tongue approach is a simple and less technically demanding approach for the
surgeon that can be used in management of the majority of the distal humeral fractures,
giving adequate exposure of the surgical field, aiding in proper reduction of fracture
fragments and thus obviating the need for an olecranon osteotomy

Functional outcome and radiological union in operated cases of AO type 12-B1 fractures of distal shaft humerus with interfragmentary screws and lateral anatomical plate

Gopal Tukaram Pundkare, Anish Nandkumar Tawde

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1568-1581

Background: Extra-articular distal shaft humerus fractures at the junction of cylindrical and triangular portion are seen as torsion wedge fractures. Historically most shaft fractures were treated conservatively. Today’s trend is towards surgical management due to high patient demand and availability of anatomical plates. This study aims to evaluate the functional results of plating in extra-articular distal humerus fractures with duration of clinical and radiological union.
Methods: A prospective study of 20 patients with torsion wedge fractures of AO Type 12-B1 was done over a period of 3 years. Demographic data was collected and all patients underwent fixation with posterior triceps splitting approach using an extra-articular distal humerus plate (EADHP) and inter-fragmentary screws. Results were evaluated by clinical and radiographic parameters. Functional results were monitored by modified Quick DASH score.
Results: There were 12 males and 8 females with a mean age of 34.45 years. Mean time to clinical and radiographic union was 10.5 weeks and 33.9 weeks respectively. The mean modified Quick DASH score at clinical and radiographic union was 24.8% and 13.76% respectively. Two patients developed radial nerve neuropraxia recovering spontaneously. One patient having inadequate reduction went on to unite both clinically and radiographically with good functional out come without any secondary intervention.
Conclusion: AO Type 12-B1 humerus fractures treated surgically with anatomical locking plates and inter-fragmentary screws give excellent anatomical and functional results. Though time to radiographic union is prolonged, no secondary intervention in the form of bone grafting or other modalities was required in any patient.

A Hospital Based Observational Study to Assess the Early Mobilization and Functional Outcome of Distal Humerus Fracture (AO Type 13-C) Treated with Open Reduction and Internal Fixation with Bi-Columnar Plating at Tertiary Care Centre

Pradeep Kumar Mundotiya, Ravindra Kumar Saini, Amit Kumar, Ratan Lal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10936-10944

Background: Patients treated with bi columnar locking compression plates show a greater
functional range of motion, better restoration of articular congruity, secure bony fixation,
better bone healing, and early rehabilitation. The aim of this study to assessed whether distal
humerus fractures (AO type 13-C) treated with open reduction and internal fixation with bi
columnar plating allows early mobilization and improves functional outcomes in patients and
also to assess its associated complications.
Materials& Method: This is prospective study where in consecutive 50 cases of distal
humerus fractures (AO type 13C) admitted in orthopedic ward in SMS Medical College,
Jaipur, Rajasthan, India during one year period. Functional outcome was assessed through
The Mayo Elbow Performance Score. All the cases in the study were posttraumatic. Patients
were following u pregularly for a period of 1year post operatively.
Results: The mean age of patients was39.68 years,withthe youngest being 21years and oldest
is 80years. Male to female ratio was 2.3:1. In 32patients left side was involved and in
18patients had right side involved. 30cases were due to Road traffic accidents and 20cases
due to self-fall. 48patients had a closed type and only two patients had an open typeII
fracture. The mean arc of movement in the flexion–extension plane was 116.780 with a mean
fixed extension of 8.560. MEPS was excellent in 35 patients, good in 8 patients, fair in 5
patients and poor in 1patient at end point of follow up. Patient with poor score had severe
stiffness and experienced difficulty in performing daily routine activities.
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 9, Issue 3, Winter 2022
Conclusion: We concluded that distal humerus fractures operated with bicolumnar locking
compression plates using trans olecranon approach by chevronosteotomy has good functional
outcome with particular advantage in intra-articular typeC3 which allows early mobilization
of the patients even in fractures with comminution due to the enhanced stabilityof the