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Case Report

Fixation of Distal Humerus Fracture Preserving the Extensor Mechanism of Elbow

R.B. Uppin , R.B. Uppin , Siddharth Baheti

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Journal of Orthopedic Education 1(2):p 75-79, July - December 2015. | DOI:

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Abstract

 Introduction: Intra-articular fracture of the distal humerusis a relatively rare injury &constitutes 0.5% to 0.7% of all fractures and 30% of elbow fractures. Traditionally these fractures have been managed operatively with various extensor mechanism disrupting approaches which are often associated with delayed/non union of the olecranon, triceps muscle weakness and osteotomy related implant prominence. Open Reduction and internal fixation of these fractures can be effectively accomplished through an ‘EXTENSOR MECHANISM on APPROACH.’We present a detailed description of surgical technique and management of Compound Intra- articular fracture distal end of humerus. Case Report: 25 year old male patient came to our Hospital following a fall from a height of 20 feet on his right elbow. Patient had a Compound Type III B injury (Gustillo Anderson Classification) with type C 2 distal humerus fracture. The fracture was initially managed with debridement, surgical toilet and external fixator application. This was followed with two weeks of regular wound care supplemented with parentral antibiotics. After the wound condition improved, definitive fixation of the intra-articular fracture was done with dual plating through an extensor mechanism on approach. Conclusion: Intra-articular fractures of distal humerus can be treated safely and successfully through extensor on approach which avoids extensor mechanism disruption and also avoids complications of olecranon osteotomy. This approach can be converted to conventional olecranon osteotomy if required intra-operatively. 

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