Fractures of Distal Humerus Operated with Using Lambda Plate
Background: The goal of this study to determine functional outcome of open reduction and internal fixation with Lambda plate for intra/extra articular distal humerus fractures. Methods: 35 patients of communited intra-articular fractures distal humerus were operated. Out of 35, 23 (65%) were male, 12 (35%) were female, mean age of 38 year (range 17-67 years). According to classification proposed by Rise borough and Radin based on radiographic analysis, out of 35, 11 (31%) were type 2, 20(57%) were type 3 and rest of the patients were type 4 fractures. All fractures fixed with Lambda plate, inter- condylar fracture fix with malleolar screw or k-wire or both after trans olecranon osteotomy. Results: Mean follow-up of 11 months (range 6-15 months). Out of 35 patients 29 patients have complete radio-logical union within 4 months. None of the fracture go into non-union.
Mean active elbow flexion was 1300 (range 900-1400) and active extension 150 (range 0-300), mean elbow flexion range exceeds 100 degree in 28 patients (80%), was between 600 and 1000 in 6(17%) and was less than 600 in one patient. Mean Mayo Elbow Performance Score (MEPS) was 96 points (range 40-100). There were 30 excellent result (MEPS) 90-100 points, 2 good (75-89) 2 moderate result. Conclusion: Fracture of distal humerus fix with Lambda plate, malleolar screw after trans- olecranon osteotomy gave excellent results in term of fixation, stability and recovery of elbow functions.
(2) A. Nauth, M.D. McKee, B. Ristevski, J. Hall, E.H. Schemitsch. Distal humeral fractures in adults. J Bone Joint Surg Am, 93 (2011), pp. 686700
(3) R.A. Sanders, E.M. Raney, S. Pipkin. Operative treatment of bicondylar intraarticular fracture of the distal humerus. Orthopedics, 15 (1992), pp. 159-163
(4) M. Luegmair, E. Timofiev, J.M. Chirpaz-Cerbat. Surgical treatment of AO type C distal humeral fractures: internal fixation with a Y- shaped reconstruction (Lambda) plate. J Shoulder Elbow Surg, 17 (2008), pp. 113-120
(5) D. Ring, L. Gulotta, K. Chin, J.B. Jupiter. Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. J Orthop Trauma, 18 (2004), pp. 446-449
(6) J.N. Doornberg, P.J. van Duijn, D. Linzel, D.C. Ring, D. Zurakowski, R.K. Marti, et al. Surgical treatment of intra articular fractures of the distal part of the humerus. Functional outcome after twelve to thirty years.