title: Distal humeral coronal plane fractures: management, complications and outcome.
abstract: BACKGROUND
  Coronal plane fractures of the distal humerus have special characteristics in classification, imaging, surgical approaches, materials used, treatment modalities, and complications. The purpose of this study is to comment on these topics.
  
  
  METHODS
  A retrospective analysis was done for patients with distal humeral coronal plane fractures. They were classified according to Dubberley and functionally evaluated by Mayo Elbow Performance Index (MEPI). The long-term complications were evaluated.
  
  
  RESULTS
  There were 15 patients, with type 1 fractures in 2, type 2 in 6, and type 3 in 7. All patients were treated by open reduction and internal fixation either by lateral or posterior approach. The average MEPI score was 83.3 (range, 60-100) points with 7 excellent, 2 good, and 6 fair results. The MEPI scores of type 3 fractures were significantly lower than those of types 1 and 2 fractures (P = .037 and P = .002, respectively). The complications were avascular necrosis in 4 (27%) patients, degenerative arthritis in 6 (40%), joint step-off in 6 (40%), heterotopic ossification in 7 (47%), nonunion in 1 (7%), and implant failure in 1 (7%). The presence of avascular necrosis and joint step-off were significantly associated with degenerative arthritis (P = .004 and P = .005, respectively). Heterotopic ossification was significantly associated with presence of lateral epicondyle fracture (P = .004).
  
  
  CONCLUSIONS
  Type 1A and 2A coronal plane fractures typically had an excellent outcome. However, type 3 and subtype B fractures are prone to developing complications which are primarily avascular necrosis, degenerative arthritis and heterotopic ossification.
authors.affiliation: 2nd Department of Orthopaedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey. odurakbasa@yahoo.com
authors.forename: Mehmet Oguz
authors.initials: MO
authors.lastname: Durakbasa
authors.forename: Gurkan
authors.initials: G
authors.lastname: Gumussuyu
authors.forename: Mutlu
authors.initials: M
authors.lastname: Gungor
authors.forename: Mehmet Nurullah
authors.initials: MN
authors.lastname: Ermis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000145:classification* / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult