Clinical and functional outcomes after type B-C (AO/OTA) distal humeral fractures treated with locking compression plates: a retrospective study

BACKGROUND: B-C (AO/OTA) fractures of distal humerus are lesions difficult to treat with results that are not always satisfactory. The aim of this study was to evaluate the outcome of patients with this type of fractures treated at our institute. METHODS: A retrospective study considering 32 patients with mean age of 57.1 years (19-85) treated with open reduction and internal fixation (ORIF) for distal humerus articular fractures, 5 type B1. 1 type B2, 12 type C1, 4 type C2, 10 type C3 (AO/OTA), 29 closed fractures, 2 with grade I-II (Gustillo) of exposure, 1 with point exposure. Surgical exposures used are triceps-on and olecranon osteotomy, while the synthesis was performed with locking compression plates. The average follow-up was 42.7 months (79-9). The radiograms performed during the standard controls were evaluated and the Mayo Elbow Performance Score was used for functional evaluation. RESULTS: Average MEPS of 90.6 (55-100), excellent in 68.8%, good 18.7%, fair, 6.3% and poor 6.3%. Average flexion of 125.1 degrees(40-140 degrees) with an average deficiency of 11 degrees (0-40 degrees). All olecranial osteotomies healed, no pseudoarthrosis was found. Registered complications: 2 wound dehiscences, 7 cases with residual hypoesthesia in the territory of the ulnar nerve, 1 mobilization of a healed fracture screw, 3 cases with presence of joint ossifications and marked rigidity with subsequent surgical revision. CONCLUSIONS: ORIF with orthogonal construct and locking compression plates is an optimal technique for the treatment of distal humerus articular fractures. Associated with an early mobilization leads to an excellent functional result with a minimum rate of complications.