Functional Outcome of Surgical Management of Intra Articular Fractures of Distal Humerus in Adults

Background: Fractures of the distal humerus, particularly intra-articular types, continue to pose significant challenges due to the complex anatomy and biomechanics of the elbow joint.

Objective: This prospective study aims to evaluate the functional outcomes and determinants following surgical management of intra-articular distal humerus fractures in adults.

Subjects and Methods: This prospective hospital-based study was conducted from January 2017 to June 2018. Thirty adult patients with intra-articular distal humerus fractures were enrolled after obtaining informed consent. Thirty patients aged over 18 years underwent open reduction and internal fixation utilizing either parallel or orthogonal dual plating techniques via a transolecranon approach.

Results: Outcomes were assessed over six months using the Mayo Elbow Performance Score (MEPS), range of motion, union rates, and incidence of complications. The mean age was 38.4 years, with a predominance of males (60%). Road traffic accidents accounted for 63.3% of injuries. Radiologic union was achieved in all patients at an average of 12.87 weeks. The mean flexion-extension arc measured 104.5°, and the mean MEPS was 82.83, with 83.3% of patients attaining good to excellent results. No statistically significant differences were observed between parallel and orthogonal plating techniques regarding functional outcomes or complications. Complications were minimal and effectively managed.

Conclusion: The study concludes that dual plating techniques, when combined with adherence to surgical principles and early mobilization, result in satisfactory functional outcomes in intra-articular distal humerus fractures.