Open Reduction and Internal Fixation of Intraarticular Fractures of the Humerus: Evaluation of 33 Cases

BACKGROUND Standard treatment of type C elbow fractures is open reduction and internal fixation using reconstruction plates and pins. OBJECTIVES The aim of this study was to evaluate the functional outcome following internal fixation of intraarticular fractures of the distal humerus (AO Type C) with a minimum follow-up of three years. A retrospective evaluation was undertaken. PATIENTS AND METHODS Thirty-three patients (28 males, 5 females; mean age 34.3years) type C elbow fractures were treated and observed over a period of three years. Six fractures were open and 27 closed; causes were falls (7 cases), traffic accidents (22 cases) and altercation (4 cases). All operations were performed using a posterior approach with an olecranon osteotomy. Mean duration of follow-up was 18 months (range 6-36). Mean duration of fracture healing was 2.3 months (range 2-4). Functional outcomes were assessed by Jupiter criteria. RESULTS Excellent results were found in 69.7% (23 cases), very good reaults and good results were found in the remaining 30.3% (10 cases). Three of 33 patients 9% (3 cases) presented postoperative complications. No patient exhibited symptoms of ulnar nerve injury following surgery. One patient had cubitusvarus deformities and one case had heterotopic ossification. One patient had malunion and one case had deep infection. CONCLUSIONS Complications were minimal and outcomes were satisfactory in patients with type C distal humerus fractures who underwent bilateral plate fixation via a posterior approach.