ORIF with orthogonal plating in the management of complex distal humerus fractures - A prospective study of 30 patients

Abstract

Fractures of the distal humerus are quite challenging to treat due to the intraarticular nature of the fracture. They are compounded by factors such as gross comminution and osteoporosis, especially in the elderly age group. This study was performed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures with orthogonal plating. Thirty patients with complex intraarticular fractures of the distal humerus who presented between April 2011 to April 2014 were managed with ORIF with orthogonal plating. They were followed up for three years. Functional evaluation was performed using the MEPS (Mayo elbow performance score) and the DASH score (Disabilities of arm, shoulder and hand). The right elbow was more commonly affected, as seen in 16 patients, and the most common mode of injury was road traffic accidents. The average time to fracture union was 11.6 weeks. The mean MEPS score was 88.5±11.6 with 85.6% of patients having a good or excellent outcome, and the mean DASH score was 23.2 points. ORIF with orthogonal plating of complex intraarticular distal humerus fractures provides a stable fixation construct and gives good functional outcomes to the patient.