Treatment of Intercondylar Fracture of Distal Humerus in Adults by Double Plate

Aim- To know the outcome of treatment of intercondylar fracture (C1 and C2) of distal humerus in adults with double plates in Regional Institute of Medical Science, Imphal, Manipur India. Introduction: Fractures of distal humerus in adults represent approximately 2 % of all fractures and a third of all humeral fractures. These injuries often present with articular comminution and require anatomical restoration of the joint surface with stable and rigid internal fixation that allows early motion. Material and Methods: In Regional Institute of Medical Sciences, Imphal, Manipur, twenty consecutive patients with intercondylar fracture ( C1 and C2) of distal humerus were treated using standard dorsal approach, olecranon osteotomy and double plates with follow up period of 24 months. Results: Based on the Mayo Elbow Performance score (MEPS) for the present study, the final outcome for all cases was Excellent in12 (60%), Good in 7 (35%) and fair in 1 (5%) patients (Table 5). Average MEPS was 89.65. Conclusion: The plates act as an extra-medullary load bearing device, stabilising fracture fragments and ensuring early bony union. Early return of joint functions is easily achieved concurrent with fracture healing. Keywords: Distal humerus, double plating, Intercondylar fracture (C1,C2), internal fixation, olecranon osteotomy. I. Introduction Fractures of distal humerus in adults represent approximately 2 % of all fractures and a third of all humeral fractures 1 . Most low-energy distal humeral fractures are produced from simple falls in middle-aged and elderly females in which the elbow is either struck directly or axially loaded in a fall onto the outstretched hand. Road-traffic accidents and sport are a more common cause of injury in younger males 1 . The treatment of these fractures continues to present challenges despite advances in internal fixation. These injuries often involve articular comminution, and many occur in older patients with osteoporotic bone. Joint function often is compromised because of stiffness, pain, and weakness. But outcomes have been improved with advances in implant technology, surgical approaches, and rehabilitation protocols. Most distal humeral fractures in adults must be treated operatively. These injuries require anatomical restoration of the joint surface with stable and rigid internal fixation that allows early motion 2 .