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Outcome of primary internal fixation of (type C) distal humerus fractures in the elderly

Résultats de la fixation interne primaire des fractures distales de l’humérus chez le vieillard

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Abstract

The aim of this review is to evaluate the functional results of open reduction and internal fixation of AO type C distal humerus fractures in elderly patients. Twenty patients were recruited in this study with an average age of 73.5 years. AO principles were followed, using dual plating in most and inter-fragmentary screws to obtain stable fixation. Mobilisation was commenced on the first post-operative day. Functional results were 72% good or excellent using the index of Broberg and Morrey, and 93% good or excellent using the Mayo elbow performance index. The average loss of full extension was 17.3° (0–30°) and the average flexion was 131° (90–140°). Radiologically, all fractures were united at review although there was few screw loosening and one implant failure at the lateral column but this did not influence the functional outcome. In conclusion, open reduction and internal fixation of type C distal humerus fractures in elderly patients should continue to be the treatment of choice.

Résumé

Le but de ce travail était d’évaluer le résultat fonctionnel de l’ostéosynthèse des fractures de l’humérus distal (type C de l’AO) chez le sujet âgé. 20 patients dont l’âge moyen était de 73,5 ans ont été inclus dans l’étude. L’ostéosynthèse a consisté le plus souvent, selon les principes de l’AO, en une double plaque avec visage compressif interfragmentaire. Le résultat fonctionnel a été jugé bon ou excellent dans 72% des cas selon le score de Broberg et Morrey, dans 93% des cas selon le score de la Mayo Clinic. La perte d’extension moyenne a été de 17,3° (0–30°) et la flexion moyenne de 131° (90–140°). Sur le plan radiologique les fractures sont toutes consolidées à la révision, malgré quelques déplacements de vis et une fracture d’implant latéral sans conséquence sur le résultat fonctionnel. En conclusion l’ostéosynthèse est le traitement de choix des fractures de type C de l’humérus distal.

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Acknowledgments

We wish to thank the Consultants in the Orthopaedic departments at the Queen’s Medical Centre in Nottingham and the Derbyshire Royal Infirmary in Derby for their support and input in this review.

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  1. 22 Fennel Close, Uttoxeter, ST14 8UW, UK

    Ahmad M. Wafai

  2. Queen’s Medical Centre, Nottingham, UK

    Gordhanbhai G. Tank & Brian J. Holdsworth

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  1. Ahmad M. Wafai
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  2. Gordhanbhai G. Tank
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Correspondence to Ahmad M. Wafai.

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Wafai, A.M., Tank, G.G. & Holdsworth, B.J. Outcome of primary internal fixation of (type C) distal humerus fractures in the elderly. Eur J Orthop Surg Traumatol 16, 114–119 (2006). https://doi.org/10.1007/s00590-005-0060-1

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  • DOI: https://doi.org/10.1007/s00590-005-0060-1

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