Selection of approach and fixation in the treatment of type C fracture of distal humerus in adults.
OBJECTIVE
To study the surgical treatment for distal humeral fractures in adults according to the follow-up results.


METHODS
Twenty-one cases (16 males and 5 females) of distal humeral fracture were included in this study. The average age was 42.5 years (range: 37-52 years). Fractures were classified according to the AO classification system. Nine cases of C1, 8 C2 and 4 C3-type fractures were identified. Open reduction and internal fixation were performed in all cases. A tricep-reflecting approach was adopted, and either the AO orthogonal plating or parallel plating technique was chosen, based on the fracture type. The plaster cast was removed 3 weeks after operation. Rehabilitation was encouraged during this period and afterwards. The average follow-up time was 12.2 months (range: 8-28 months). The outcome was scored according to Aitken and Rorabeek system.


RESULTS
No nerve injury, nonunion or failure of fixation was encountered during the operation and follow-up. However, ossifying myositis occurred in one case.


CONCLUSIONS
A triceps-reflecting approach can provide adequate exposure to the joint. The use of AO orthogonal plating or parallel plating techniques based on the type of fractures can provide rigid fixation for the fracture.
Department of Orthopedic Surgery, First Hospital of Jilin University, Changchun, China. xinqi@public.cc.jl.cn <xinqi@public.cc.jl.cn>
Xin
X
Qi
Jian-guo
JG
Liu
Yu-bao
YB
Gong
Chen
C
Yang
Shu-qiang
SQ
Li
Wei
W
Feng
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged