Abstract:
Introduction. Distal humerus fractures are associated with many problems like fracture
comminution, osteoporotic bone and complex fracture anatomy. Majority of the distal humerus
fractures (96%) have a complex pattern involving both the columns and the articular surface (AO
type B and C injuries). Distal humerus fractures comprise 1–2% of all fractures in adults with a
reported incidence of 5.7 per 100 000 per year.
Aim of the study. To evaluate the intermediate term results (follow up of two years) of distal
humerus fractures according to data from medical records, implementation of AO classification
(Arbeitsgemeinschaft für Osteosynthesefragen) and its codification, type of implant used in
fracture fixation, specific parameters of elbow postsurgical treatment.
Materials and methods. We have proposed a study of patients with distal humerus fractures
(DHF) which consecutively was treated in departament of Hand Pathology with the application
of microsurgical techniques (6 Section) of Traumatology and Orthopedics Clinical Hospital,
Chisinau in the period 2016-2017. Final outcomes were determined by using Disabilities of Arm
and Shoulder and Hand (DASH) score and the Mayo Elbow Performance (MEP) score
calculated along with complete range of motion. All results were presented as mean ± standard
deviation (±SD).
Results. According to AO codification of DHF were determinate type A – 10, type B – 6, type C
– 40 and in total were investigate 56 patients. The report between sex was 3:1 (42:14) with
predomination of female gender. In three cases was achieved close reduction of FHD type A and
fixation was obtained with k-wires. In rest patients were apply open reduction and internal
fixation according to AO types of FDH in type A – 2 case was use k-wire an tension bands – and
one case orthogonal plating; type B – lag screw in 2 cases and k-wires fixation in 4 cases; in type
C was the main goal to obtain the triangular stability with restauration of three columns and were
used k-wire an tension bands in 20 cases, orthogonal plating in 9 cases and at 11 cases parallel
plating. All fractures healed, and radiographic union was observed at an average of 3 months. Was possible to investigate MEP and DASH scores at 19 patients with a mean of 85±17 and
39±23.
Conclusions. Outcome of open reduction and internal fixation of distal humerus fractures can
result in high union rates with acceptable outcome DASH and MEP scores.
