Background
The treatment of extra-articular distal humerus fractures is still controversial; conservative treatment in a cast or a brace may result in good outcomes, but arthofibrosis and loss of range of motion are major disadvantages. Open reduction and rigid internal fixation provide axial stability and early range of motion, but the short distal metaphyseal fragment makes secure and rigid fixation difficult.
Patients and methods
Thirty patients with 30 extra-articular distal humerus fractures underwent open reduction and internal fixation by double reconstruction plates in the Misr University for Science and Technology hospital in the period from January 2006 to January 2010. The age of the patients ranged between 24 and 52 years. The mechanism of injury was a fall from the ground level in 15 patients, a fall from a chair or a ladder in two patients, a road traffic accident in eight patients, and a direct hit to the elbow in five patients. The follow-up period ranged from 12 to 36 months. The patients were evaluated clinically, radiologically, and by the Mayo Elbow Performance Score.
Results
Union was achieved in 28 patients after 8 weeks; two patients with delayed union were treated by a bone graft and no cases of nonunion were encountered. Excellent and good results were achieved in 21 patients, six patients showed fair results, and three patients showed poor results.
Conclusion
The treatment of extra-articular distal humerus fractures by double reconstruction plating provides axial stability, allows early range of motion, and there is a lower risk of stiffness, with no reported cases of hardware failure.