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Background: Extra-articular distal humerus fractures are difficult and challenging entities to manage owing to the complex anatomy of distal part of humerus as well as complicated fracture morphology. Functional cast bracing does not provide adequate stabilisation of these fractures apart from having other brace related complications. To overcome this problem, surgical intervention is the preferred method of treating these fractures with its share of complications like infection, non-union, implant failure and iatrogenic radial nerve palsy. Intra-medullary nailing and fixation with conventional plates is not a good option due to inadequate fixation in short distal fragment. The use of pre contoured, extra-articular distal humerus plates have emerged as a standard treatment in managing such fractures. This study was aimed to evaluate the clinical and functional outcome of managing such fractures using extra-articular distal humerus locking plates. Methods: This retrospective study was carried out at Integral Institute of Medical Sciences And Research, Lucknow from September 2013 till August 2016. Out of the 47 patients records analysed, only 25 patients qualified for this study. All the patients were operated using the posterolateral triceps reflecting approach to the humerus. All the fractures were fixed using extra-articular distal humerus locking plates. All the patients were followed for 12-18 months with a mean of 16 months. The clinical and functional outcome was assessed using the Mayo Elbow Performance score (MEPS) for elbow and University of California Los Angeles (UCLA) rating scale for the shoulder function. Results: At the final follow-up according to MEPS we had 18 patients showing excellent results (72%), 6 had Good results (24%) and 1 patient had Fair results (4%). According to UCLA, we had 22 patients (88%) Excellent results, while remaining 3 patients (12%) had Good results at final follow-up. No case of malunion or non-union was reported in our study. 1 patient developed superficial infection which was managed by daily dressing. 2 patients developed post-operative radial nerve palsy which recovered spontaneously. In 1 patient implant removal was warranted due to prominence of the hardware but that too after the fracture had united. Conclusion: Stable fixation of these fracture and early mobilisation of the elbow joint are the key features to have an optimal outcome after the surgery. Using the pre contoured, extra-articular distal humerus locking plate with minimal soft tissue stripping has yielded good results with early return to normal function.

international journal of orthopaedics sciences

Functional outcome of treatment of extra articular distal humerus fractures using pre contoured distal humerus locking compression plate: A retrospective study