Abstract:
Introduction. Distal humerus fractures have a complex pattern involving both the columns
and the articular surface (AO type B and C injuries) and represent 30% of all elbow fractures,
with a reported incidence of 5.7 per 100,000 per year in adults. Federer et al. (2019) estimate a
total cost of 20.669 dollars on 12 patients with complete articular fracture of the distal humerus.
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 surgery, type of implant used in fracture
fixation, economic management, specific parameters of elbow post-surgical treatment.
Materials and methods. We have proposed a study of surgical and economic management
patients with distal humerus fractures (DHF) which consecutively was treated in the
Department of Hand Surgery with the application of microsurgical techniques of Traumatology
and Orthopedics Clinical Hospital, Chisinau in the period 2018-2019.
Results. According to AO codification of DHF were determinate type A – 11(A1-1; A2-9;
A3-1) , type B – 10(B1 - 2; B2 - 2; B3 -6 ), type C – 35(C1-26; C2-4; C3-5 ) and in total were
investigate 56 patients. The report between sex was 2,5:1 (40:16) with a predominance of the
female gender. In three cases was achieved a 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 – 9 case was used k-wire a tension bands – and 2 case
orthogonal plating; type B – lag screw in 6 cases, k-wires fixation in 3 cases, platting 1 case;
in type C was the main goal to obtain the triangular stability with restoration of three columns
and were used k-wire, screws and tension bands in 29 cases, orthogonal plating or parallel
plating in 8 cases. In distal humerus fractures, surgery was used 11 plates, 101 screws, 258 kwires,
30,1 m of metallic wire and the total cost of these implants is 11385,8 MDL per total
care cost of 28582,65 MDL.
Conclusions. Economic management of open reduction and internal fixation of distal humerus
fractures have potential volume and need improvement to fit the standard of absolute stability
in osteosynthesis with plates of distal humerus fractures.
Description:
Department of Orthopedics and Traumatology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020