Surgical Treatment of the Fracture of the Distal Humerus

Choi, Chang Hyuk; Kwun, Koing Woo; Kim, Shin Kun; Lee, Sang Wook; Han, Soo Il; Kang, Chang Jin

Abstract

The treatment of the fracture of the distal humerus has remained one of the most difficult of all fractures to manage. The goal of treatment, which is the same for other intraarticular fractures, is to reestablish articular congruity, rigid fixation and early active motion as soon as possible. It appears that the use of plates is currently the most acceptable method of fixation. The aim of this study is to clarify the correlation between various fixation methods and functional end results, in order to help in choosing treatment modalities. We reviewed 11 cases of the fractures of the distal humerus treated surgically in Orthopaedic Department of Taegu Hyosung University Hospital between 1992 and 1995. Clinical end results were as follows: 1. Of the 11 cases, there was 6 males and 5 females. Age was from 13 years old to 83 years old and mean age was 46 years old. 2. Muller classification consisted of 4 cases of A2, 1 case of B2, 3 cases of Cl and 3 cases of C2. The mean length of follow up was 15 months. Except for 2 cases of open wound and nonunion, time from injury to surgery was 8 days. Mean period of initial exercise was 4 weeks. 3. All surgical incisions were done with posterior approach; they consisted of 5 cases of dual-contoured plates, 4 cases of plate with screw and 2 cases of K-wires with screw. 4. Mean range of elbow motion was flexion 123 and extension defect 14. There was no limition of pronation and supination compared with the normal side. 5. The functional result by Jupiter criteria was excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 1 case. 6. There were complications in 1 case of plate broken and 1 case of nonunion. 7. In the distal fracture of the humerus, There were 82% of excellent of good result by over-all functional result of Jupiter.