DOI: https://doi.org/10.22141/1608-1706.3.20.2019.172095

Results of treatment of patients with distal humerus fractures and their consequences

I.M. Kurinnyi, O.S. Strafun

Abstract


Background. Distal humerus fractures are only 2 % of all fractures of the skeletal bones in adults and 30 % of all fractures in the area of the elbow joint. The purpose of the study was to analyze the results of treatment in patients with fractures of the distal epimethaphysis of the humerus and their consequences, depending on severity of injury. Materials and methods. From 2011 to 2018, 132 patients with distal humerus fractures were observed. The average age of patients was 39.6 ± 15.1 years; there were slightly more men than women (53.8 and 46.2 %, respectively). All patients were operated with open reposition and osteosynthesis of humerus with angular stability plates. Long-term treatment outcomes were evaluated in 95 (71.97 %) persons. All patients were divided into two groups. The first group consisted of 44 individuals (46.32 %) with fresh fractures. The second group included patients with old trauma (more than 2 months), false joints and malunions of this localization (51 persons, 53.68 %). On average, patients in the first group were examined 19.2 ± 7.1 months after surgery, and in the second group — 16.3 ± 5.2 months after. Results. Most fractures and olecranon osteotomies consolidated clinically and radiologically (90.91 % patients in the first group and 86.27 % in the second group) without displacements along the articular surface (> 2 mm) and without angular deformations (> 10°). In the majority of patients of the first group, consolidation occurred within 4 months after the operation, while in patients of the second group, this time on average was 6 months. In both groups, 26 complications were observed (27.37 %). The average Mayo Elbow Performance Score was 88.48 ± 15.12 points in group I and 83.94 ± 16.89 points in group II; 86.36 % of patients in group I and 78.43 % in group II had excellent or good treatment results. Considering the subjective evaluation of the operation by patients, 76 persons from both groups (80.0 %) were satisfied with surgical intervention. Conclusions. The results of operative treatment in patients with the consequences of distal humerus fractures had no significant differences from fresh cases, but depended on the severity of the previous injury, the presence of deformation, nonunion or severity of elbow joint contracture, which was observed at the beginning of treatment.


Keywords


fractures; humerus; olecranon; surgical intervention

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