Evaluation of the Functional Outcome in Intra-Articular Distal Humerus Fractures Treated by Dual Plating

Vinod Bhuktar; Mihir R. Patel; Bibhas DasGupta; Mahesh B. Shinde; Karthik HK; Kshitij  Sarwey; Sanket Jethliya; Pushti Shah; Anika Zaveri; Yash Nav Singh; Meghana  Date; Yash Jain; Shreyas Revankar; Siddhart Mitra

doi:10.18502/jost.v11i3.19405

Vinod Bhuktar Senior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Mihir R. Patel Additional Professor, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Bibhas DasGupta Professor, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Mahesh B. Shinde Senior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Karthik HK Senior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Kshitij Sarwey Junior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Sanket Jethliya Junior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Pushti Shah Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Anika Zaveri Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Yash Nav Singh Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Meghana Date Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Yash Jain Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Shreyas Revankar Senior Resident, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India
Siddhart Mitra Medical Student, Department of Orthopedics, H.B.T Medical College and Dr R.N. Cooper Hospital, Juhu, Mumbai, India

DOI: https://doi.org/10.18502/jost.v11i3.19405

Keywords: Distal Humeral Fractures; Intra-Articular Fractures; Elbow Joint

Abstract

Background: The complex anatomy of the elbow joint, multiple displaced fragments, and intra-articular extension of the fracture make these cases challenging to treat and prone to complications. Several methods of limited internal fixation, such as Kirschner wires (K-wires), screw fixation, and single plates, have been described. However, these methods do not provide sufficient stability for early mobilization and often yield unpredictable results. The latest generation of pre-contoured anatomical compression locking distal humerus plate systems offers angular stability and rigid fixation for intra-articular distal humerus fractures. This study aims to evaluate the clinical outcomes of distal humerus fractures using dual plate fixation.

Methods: After ethics committee approval, this prospective observational study was conducted over a period of 26 months on 20 patients with intra-articular distal humerus fractures. Functional outcome was measured by using the Mayo Elbow Performance Score (MEPS) system. Radiological union was checked at regular intervals.

Results: Olecranon osteotomy (65%) showed better outcomes than the paratricipital approach (35%), with 60% of patients achieving excellent MEPS scores at 24 weeks. Radiographic union was observed in 60% of patients by 12-14 weeks, 25% by 16-18 weeks, and 15% by 18-20 weeks [mean ± standard deviation (SD) = 15.00 ± 2.83 weeks]. Mean range of motion (ROM) improved significantly from 65.83 ± 14.89 degrees at 6 weeks to 102.50 ± 15.88 degrees at 24 weeks (P < 0.01). Complications included one case each of wound infection, hardware protrusion, and stiffness, managed with antibiotics or physiotherapy.

Conclusion: The dual locking plating for intra-articular humerus fracture may be a better option in terms of stable and rigid fixation, functional outcome, and fewer complications.