Outcome of Distal Humeral Fractures: An Experience to Evolve
DOI:
https://doi.org/10.51253/pafmj.v75iSUPPL-6.13587Keywords:
Elbow Joint, Fracture Fixation, Humeral Fractures, Outcome Assessment.Abstract
Objective: To evaluate the functional outcomes of distal humerus fracture fixation using locking plates and screws, focusing on fracture reduction, fixation stability, and post-operative recovery as measured by the Mayo Elbow Performance Score (MEPS).
Study Design: Cross sectional study.
Place and Duration of Study: Pakistan Navy Station Shifa Hospital, Karachi Pakistan, from Jan 2019 to 30 Jun 2021.
Methodology: A total of 19 patients aged 18-65 with closed distal humerus fractures were included in the study. All patients underwent open reduction and internal fixation (ORIF) using locking plates. The primary outcome was functional recovery assessed using the Mayo Elbow Performance Score (MEPS) at 3 and 6 months post-operatively. Secondary outcomes included complication rates, time to union, and patient adherence to post-operative rehabilitation.
Results: At 6 months, the mean MEPS score was 72.37±8.39, with significant improvement from the 3-month follow-up. Males showed better recovery than females (p=0.032). Two patients (10.5%) experienced mild surgical site infections, and one patient (5.3%) had delayed union. Notably, 89.5% of patients missed regular rehabilitation sessions, which negatively impacted their functional outcomes. Fracture union occurred in an average of 20 weeks.
Conclusion: Locking plate fixation provides stable fracture fixation and satisfactory functional outcomes for distal humerus fractures. Gender and compliance with rehabilitation were significant factors influencing the outcomes in this study.
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References
1. Yetter TR, Weatherby PJ, Somerson JS. Complications of articular distal humeral fracture fixation: A systematic review and meta-analysis. J Shoulder Elbow Surg 2021; 30(8): 1957-1967.
https://doi.org/10.1016/j.jse.2021.01.016
2. Yadav V, Ganie PA, Prasad RP, Jeyaraman M. Management of intercondylar fractures of the distal humerus in adults using bi-columnar plating through trans-olecranon approach. Int J Res Orthop 2021; 7(6): 1156.
https://doi.org/10.18203/issn.2455-4510
3. Stoddart MT, Panagopoulos GN, Craig RS, Falworth M, Butt D, Rudge W, et al. A systematic review of the treatment of distal humerus fractures in older adults: A comparison of surgical and non-surgical options. Shoulder Elbow 2024; 16(2): 175-185.
https://doi.org/10.1177/17585732221099845
4. Sarker MA, Fattah IU, Hossain SN, Roy SK, Billah MB, Paul R, et al. The outcome of precontoured distal humeral locking plate & humeral reconstruction plate in the treatment of humeral intercondylar fractures. J Surg Res 2024; 7(4): 466-470.
5. Bahroun S, Grami H, Kacem MS, Aloui A, Jlalia Z, Daghfous MS. Comparative analysis of two double-plate fixation techniques for intercondylar fractures of the distal humerus. Sci Rep 2024; 14(1): 23913.
https://doi.org/10.1038/s41598-024-73299-7
6. Mahajan NP, GS PK, Ravesh VA, Palange ND, Varekar SS. Study of functional outcome of surgical management of distal humerus fractures with bicolumnar plating. J Orthop Spine 2020; 8(2): 75-79.
https://doi.org/10.4103/JOASP.JOASP_15_20
7. Greiner S, Haas NP, Bail HJ. Outcome after open reduction and angular stable internal fixation for supra-intercondylar fractures of the distal humerus: Preliminary results with the LCP distal humerus system. Arch Orthop Trauma Surg 2008; 128: 723-729.
https://doi.org/10.1007/s00402-007-0444-1
8. Imatani J, Ogura T, Morito Y, Hashizume H, Inoue H. Custom AO small T plate for transcondylar fractures of the distal humerus in the elderly. J Shoulder Elbow Surg 2005; 14(6): 611-615.
https://doi.org/10.1016/j.jse.2005.03.008
9. Azim Q, Khan AH, Mufti AJ. Functional outcome of distal humerus intercondylar fractures treated with dual plating. Rawal Med J 2022; 47(2): 373-376.
10. Wilfred AM, Akhter S, Horner NS, Aljedani A, Khan M, Alolabi B. Outcomes and complications of distal humeral hemiarthroplasty for distal humeral fractures: A systematic review. Shoulder Elbow 2022; 14(1): 65-74.
https://doi.org/10.1177/17585732211023100
11. El Mohsen Sherif OA. Distal humerus fracture fixation using anatomical distal humerus plate. Int J Health Sci 2025; 9(S1): 73-87.
https://doi.org/10.55302/ijhs.v9nS1.15559
12. Patel I, Amin TK, Makwana VR, Prajapati MM, Patel AV, Modi DR, Kavi SK. Results of intra-articular distal humerus fracture treated with open reduction and internal fixation. J Orthop Dis Traumatol 2023; 6(1): 3-6.
https://doi.org/10.4103/jodp.jodp_61_22
13. Wali A, Chaudhry K, Hussain H, Nawazish UA, Saddiq S, Akram R. A review on functional outcomes of intra-articular distal humerus fractures treated with recon plate using Mayo Elbow Performance Score (MEPS). Prof Med J 2023; 30(10): 1253-1258. https://doi.org/10.29309/TPMJ/2023.30.10.7411
14. 14 Islam SU, Glover AW, Waseem M. Challenges and solutions in management of distal humerus fractures. Open Orthop J 2017; 11: 1292. https://doi.org/10.2174/1874325001711011292
15. Gupta RK, Gupta V, Marak DR. Locking plates in distal humerus fractures: Study of 43 patients. Chin J Traumatol 2013; 16(4): 207-211.
https://doi.org/10.3760/cma.j.issn.1008-1275.2013.04.009
16. Piekarczyk P, Kwiatkowski K, Piątkowski K, Gołos J, Kuczmera P. Outcomes after open reduction and plate fixation of distal humerus fractures. Ortop Traumatol Rehabil 2015; 17(6): 627-636.
https://doi.org/10.5604/15093492.1193035
17. Sunil B, Avulapati SK, Choudhary SK, Koneru S. Functional outcome evaluation of distal humerus fracture fixation. Int J Res Orthop 2020; 6(3): 467.
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20201017
18. Saini R, Sharma A, Rathore KS, Sidhu SS. Clinical and functional outcomes of anatomical plating in distal humerus fractures in adults. Cureus 2023; 15(2): e35581.
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Copyright (c) 2025 Syed Faraz Anwar, Syed Sheheryar Anwar, Shahid Iqbal, Syeda Lyba Onaiz
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