From Biomechanical to Treatment of Complex Distal Humeral Fracture

Objective:From biomechanical to treatment of complex distal humeral fracture.Methods:From Mar 2003 to Dec 2007,23 cases of complex distal humeral fractures were reviewed,which involved 17 males and 6 females with an average age of 38.2 years (ranges,21-65 years). The fracture was located on right side in 10 and on left side in 13. According to AO/Asif classification,there were C1 in 9,C2 in 8 and C3 in 6 cases. Among them,7 cases were open fractures,6 case with ulnar never injury and 8 cases underwent never exploration and anterior transposition. Posterior trans-ulecranon osteotomy with open reduction and internal fixation by AO reconstructive plate or plus anatomic plate were performed in all cases within 72 hours after injury. The osteotomy was V shape at 2 cm to 2.5cm to proximal end of ulna. At one week postoperatively began the passive and active motion exercise. Within six week have not exercise overburdened. Results:All the cases were followed up from 8 to 65 months (average 26 months) and the elbow function recovered satisfactorily. According to Mayo scoring system,the result was assessed as excellent 8,good 11 and fair 4. The excellent-good rate was 82.6%,and C2and C3 shape was 78.6%.Conclusion:Posterior trans-olecranon osteotmoy and technique of AO reconstruction plating for complex distal humeral fractures were up to biomechamical fixation.