Fracture distal humerus: Prevention of complications
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:66
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Kumar P, Shyam A
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Introduction: Distal humerus fractures are uncommon injuries accounting for fewer than 2% of all adult fractures. It has bimodal age distribution, 14-30 years common in males and they are high energy fracture or 70 years and older commoner in females and they are low energy fractures. Complex shape of elbow, adjacent neurovascular architecture & sparse soft tissue envelope combine together to make these fractures difficult to treat. :A study was conducted on 34 adult pts. having intercondylar fracture humerus from Feb 07 to Dec12. Classification done as per Rise borough & Radin. All were closed AO type C except 2 open # I/C humerus. Majority of cases were operated within 2wks. of injury. Objective is precise reconstruction of articular surfaces, proper alignment, stable internal fixation, allowing early motion and repair of all concomitant lesions.
Material and Methods: Operative procedure consisted of ORIF with 2 3.5 reconstruction plate and screws, interfragmentary screws & Kwires. Olecranon osteotomy was fixed with TBW except 3 cases with sq. nail. In all cases, posterior transolecranon approach was used. Postoerative active mobilization started as a routine on 2nd. Day of surgery under Slab. Subsequently further Physiotherapy was advised as per individualistic effort. These pts. were followed up for minimum 18-24 mnths. Final functional result were assessed as per criteria laid down by FLYNN et al.
Result: Analysed as rate of healing of fracture, stability at elbow, degree of alignment, ROM & pain or any other complication. Result excellent in 7, good in 11 ,fair in 5 & poor in 7 cases. Complications :include stiffness elbow in 8, superficial infection in 2,deep infection in 1, heterotopic ossification, malunion, hardware failure & painful restriction of mov. in 5 cases, neuropraxia ulnar nerve 02 cases. Fractures united with a mean period 12- 20 wks. &ROM 100-150 mean 125. Overall results were satisfactory in majority of cases. 1 case of nonunion reported in our series. That case fixed with multiple K. wires. Later it failed. Finally total elbow arthroplasty was performed. Result was extremely well. Patient had 70- 110°. Conclusion: We conclude that ORIF I/C fracture in adults is a good method of t/t with early return of movement at elbow and good ADL. Total elbow arthroplasty performed in type 4 comminuted I/C fracture with gratifying result.
|How to Cite this Abstract|
|Kumar P, Shyam A . Fracture distal humerus: Prevention of complications. International Journal of Conference Proceedings 2015;(2015):66|