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Category: Volume 09 Issue 12 December 2021
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Title: Radiological and functional outcome of open reduction and internal fixation of extra articular distal humerus fracture using anatomical plate

Authors: Kiran Gurung, Vinod Kumar Thapa, Prakash Bahadur Thapa

 DOI: https://dx.doi.org/10.18535/jmscr/v9i12.22

Abstract

Introduction: Reliable techniques for the fixation of extra-articular distal humerus fractures (EADHF) impose significant challenge among the surgeons. Albeit there has been mounting proposed plate configurations, anatomic plates is an optimal solution for the management of these difficult fractures. This study was carried to evaluate the clinico-radiological outcome of EADHF at Bheri Hospital.

Methods: It is a hospital based prospective study carried out in the department of Orthopedics at Bheri Hospital, Nepalgunj, Nepal from July 1, 2018 till June 30, 2020 and patients affected with EADHF were included and managed using anatomical plates. The fractures were approached using triceps splitting posterior methods. The fracture fixation was done using anatomical distal humerus plate. Radiological union and final functional outcome using Mayo Elbow Performance score (MEPS) was evaluated.

Results: A total of 30 patients were recruited and the mean age was 40.12 ± 7.5 years. Majority of the patients were AO Type 13- A2 fracture and mean arc of motion was 98.5 ± 14.25°. The average mean time for radiological union was 18.2 ± 3.6 weeks (14 to 28) and there have been two cases of non union. The mean MEPS during the final up was 85 ± 13.8 and 20 patients showed good results.

Conclusion: Using anatomical locking plates with triceps splitting approach provides best visualization of extra-articular fracture of distal femurs. This method displays stable fixation and early reunion with minimal soft tissue loss and complications.

Keywords: Distal humerus, Extra articular fracture, Anatomical plates, Mayo Elbow Performance score.

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Corresponding Author

Dr Kiran Gurung

Orthopedic Surgeon

Western Hospital Pvt. Ltd., Nepalgunj, Nepal