Evaluation of Functional Outcomes of Intra-articular Fractures of Distal Humerus by Open Reduction and Internal Fixation

Introduction: Different points of view exist regarding choice of surgical approach and of implants in management of distal humerus intra-articular fractures. The results of open reduction and internal fixation of these fractures are variable in terms of functional outcome. Aim: To evaluation of results of surgical fixation of intraarticular distal humeral fractures with Arbeitsgemeinschaft fur Osteosynthesefragen (AO) reconstruction plates in terms of functional outcome. Materials and Methods: A total of 20 patients with infraarticular fractures of distal humerus were operated with open reduction and internal fixation using olecranon osteotomy approach. Provisional fixation was done with K-wires. Interfragmentary compression was given with 4.0 mm cancellous lag screw and definitive fixation was done using 3.5 mm AO reconstruction plates and one third tubular plates. K-wire and tension band wiring fixation were used for osteotomy. Results: Approximately 90% cases were inter-condylar type C fractures. The average elbow flexion achieved at final follow up was 110.25 degrees. Approximately 75% patients showed excellent or good results based on clinical, radiological evidence of union and functional outcome which was assessed using Mayo Elbow Performance Index Score (MEPIS). Average MEPI score in this study was 86.0, based on points assigned to Pain, Motion, Stability and Function. Conclusion: Open reduction and internal fixation of distal humerus fractures gives good results after restoration of complex geometry of condyles and shaft in all three planes. The AO reconstruction plates and one third tubular plates were found to be very effective and useful in treatment of adult distal humerus intra articular fractures with good functional outcome.