title: Treatment of high-energy supracondylar/intercondylar fractures of the distal humerus.
abstract: Operative treatment of high-energy intra-articular fractures of the distal humerus is challenging and controversial. We conducted a retrospective study at a Level I trauma center to evaluate the results of a specific treatment protocol. Seventy-one patients were treated through a posterior olecranon osteotomy. Capsulectomy was performed in patients who perceived their functional range of motion to be limited after an average of 10~months. Clinical followup consisted of physical examination, radiography, and completion of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Average followup duration was 22 (range, 6 to 70) months. Sixty-five percent of the patients achieved excellent or good results, 28% fair, and 7% poor. Thirty-one percent underwent capsulectomy, with 59% of those patients achieving excellent or good results. This is the largest series reported to date. Our patients experienced mild functional impairment and a low rate of nonunion. We advocate capsulectomy for patients with limited range of motion postoperatively.
authors.affiliation: Department of Shock Trauma Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cannada
authors.forename: B
authors.initials: B
authors.lastname: Loeffler
authors.forename: M B
authors.initials: MB
authors.lastname: Zadnik
authors.forename: And W A
authors.initials: AW
authors.lastname: Eglseder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D020424:Ulnar Neuropathies / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult