EXPERIENCE IN TREATMENT OF DISTAL HUMERAL EPIMETAPHYSEAL INTRA-ARTICULAR FRACTURES USING COMBINED OSTEOSYNTHESIS BY SUBMERSIBLE SCREWS AND EXTERNAL FIXATION HINGE DISTRACTION SYSTEM

Purpose of study: to evaluate the results of distal humeral epimetaphyseal intra-articular fractures treatment by the proposed combined osteosynthesis technique.Patients and methods. From 2014 to 2017 thirty three patients (21 male, 12 female) aged 22-68 years were treated for the distal humeral epimetaphyseal intra-articular fractures of types 13B1.2 — 13B3.3, 13C1.3 and 13C3.1t by AO/OTA classification. The technique included open reposition, transchondral osteosynthesis using titanium alloy (n=18) and biodegradable (n=15) cannulated screws followed by the application of the external fixation hinge distraction system. The results were evaluated roentgenologically and by DASH Score. Results. Follow up period made up from 3 to 12 months. Fracture consolidation was achieved in all patients. Functional treatment results were evaluated by DASH Score. In 30 patients the results were assessed as excellent, in 3 — good. No poor results were recorded.Conclusion. The advantages of the proposed technique are the early initiation of active and passive movements in the operated joint to prevent contracture and posttraumatic arthrosis development, reduction of risks of fracture fragments secondary displacement and screw migration, joint unloading owing to articular surfaces dosed distraction, ensuring of the operated joint stability. The result did not depend on the type of cannulated screw used.