Distal Humeral Comminuted Intra-articular Fractures - Sally Tennant 21/2/2001

COMMINUTED, INTRA-ARTICULAR DISTAL HUMERAL #S

BACKGROUND

Type AO- C #s

First described by Desault in 1811

Uncommon #, recommendations for treatment have varied widely

MUA & POP, Skeletal traction, C&C, ORIF, excisional arthroplasty, Primary TER.

Over last 10 years, general concensus that best treated operatively.

Primary TER may have a place eg in very comminuted #s in elderly pts, RA.

Author Zagorski JB et al (Miami)
Title
Reference Clin Ortho 202:197-204 1986
Summary 42 #s, 6 yr period, FU av 26/12. Compared ORIF and early ROM in 29 with 13 non-surgical - c&c, sk traction, MUA & POP. 2 excisional arthroplasty. 76% of ORIF gp had excellent or good surgical result.
Critique Small no.s, retrospective, no classification, multiple injuries in at least 15, mixed open and closed, 2 open injuries had no debridement, no definition of "early" ROM.



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