Treatment results for open comminuted distal humerus intra-articuler fractures with Ilizarov circular external...

In open, intra-articular distal humerus fracture caused by gunshot injury, full functional recovery is difficult to obtain. Three basic treatment methods are available: minimal internal fixation, open reduction-internal fixation, and external fixation. In Gülhane Military Medical Academy Department of Orthopedics and Traumatology, 19 of 20 cases of gunshot injuries were treated with circular external fixator between the January 1995 and December 2000. Nine (45%) cases were type III-A, eight (40%) were type III-B, and three (15%] were type III-C. Eight (40%) cases were brought to the hospital 6 to 8 hours after the injury and 12 (60%) were in late stage. An amputation was done in one case. Mean follow-up period was 34.3 (14-55) months. Union was achieved in all 19 of the cases, and circular external fixator was taken out in a mean period of 4.6 (3-7) months. In the early treatment group, three (42.9%) were good, three (42.9%) were moderate, and one (14.2%) was unsatisfactory. In the late treatment group, five (41.7%) were good, four (33.3) were moderate, and three (25%) were unsatisfactory. Circular external fixator can be preferred as a treatment alternative in selected cases of distal humerus intra-articular open communited fractures because it protects the soft tissue connections and blood circulation of bone fractured, permits early elbow movements, and allows the patient to return to daily life very early.