DISPLACED - COMMINUTED INTRAARTICULAR FRACTURES OF THE ADULT DISTAL HUMERUS: FUNCTIONAL RESULTS AFTER INTERNAL FIXATION

Background: Intra-articular T -type or Y -type fractures of the distal end of the humerus are relatively rare, and consequently few surgeons will be able to attain extensive experience with the surgical treatment of these injuries. The current emphasis is on operative intervention with rigid internal fixation and early mobilization. Methods: In this prospective and retrospective study, we reviewed a series of 38 displaced-comminuted intra-articular T-type or Y-type fractures of the distal end of the humerus that were operated through the trans-olecranon approach by a single surgeon and fixed by multiple pins and/or screws over an 8 year period from June 1995-July 2003. The fracture patterns were classified according to RR (Risborough- Radin) and a strict rating scale (Jupiter et al.) incorporating subjective data, objective motion, and the functional status of the involved elbow was used for the results. Results: At a mean follow up of 18 months, 14 results were rated as excellent; 15 results as good; 6 results as fair; and 3 results as poor. Complications included postoperative ulnar nerve neuritis in one patient; non-unio‎n in one patient; elbow joint stiffness in two patients; superficial infection in three patients; and pin protrusion in three patients. Over-all follow up examination showed 76% excellent and good results, 16% fair results and 8% poor results. Conclusion: We prefer anatomical reduction and stable fixation with pin and screw with limited soft tissue dissection in adults and in old patients with good bone quality.