J Korean Fract Soc.  2012 Jul;25(3):185-190.

Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus

Affiliations
  • 1Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea. tjlee@inha.ac.kr

Abstract

PURPOSE
The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve.
MATERIALS AND METHODS
We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function.
RESULTS
Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications.
CONCLUSION
The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.

Keyword

Humerus; Distal fracture; Function of elbow joint; Radial nerve

MeSH Terms

Elbow
Elbow Joint
Follow-Up Studies
Humeral Fractures
Humerus
Paralysis
Radial Nerve
Range of Motion, Articular
Return to Work
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