Double Plating in Type C Distal Humerus Fractures: Current Treatment Options and Factors that Affect the Outcome

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Complex distal humerus fractures, specifically Type C (AO classification), present significant challenges in operative management.
• Restoring normal elbow anatomy and function is paramount for patient outcomes following these severe injuries.

Purpose of the Study:

• To evaluate the effectiveness of current operative treatment strategies for Type C distal humerus fractures.
• To assess functional outcomes and complication rates associated with a specific surgical approach.

Main Methods:

• Retrospective cohort study of 32 patients with Type C distal humerus fractures treated operatively.
• Surgical technique involved open reduction via a posterior approach, olecranon osteotomy, and parallel-plate two-column internal fixation.
• Evaluation included fracture healing, functional scores (DASH, MEPS), and complication assessment (infection, neuropathy, ossification).

Main Results:

• High rate of fracture union (90.6%) within a mean of 8 weeks.
• Mean Disabilities of the Arm, Shoulder and Hand (DASH) score of 20 and mean Mayo Elbow Performance Score (MEPS) of 83.3 indicate satisfactory functional recovery.
• Low complication rates, including one case of ulnar neuropathy and one deep infection.

Conclusions:

• The posterior approach with olecranon osteotomy and parallel plating is an effective method for treating Type C distal humerus fractures.
• Anatomic reconstruction of the articular segment is essential for achieving successful elbow function postoperatively.
• This surgical strategy facilitates fracture healing and good functional outcomes in complex distal humerus injuries.