title: Corrective Osteotomy for Intra-Articular Distal Humerus Malunion.
abstract: BACKGROUND
  An intra-articular distal humerus malunion can be disabling. To improve function, reduce pain and/or prevent further secondary osteoarthritis an intra-articular corrective osteotomy can be considered. Herein we present the indications, practical guidelines for pre- operative planning and surgical technique. Subsequently, we provide long-term results in a small series.
  
  
  METHODS
  We included six consecutive patients operated for intra-articular distal humerus malunion. Mean follow-up was 88 months. At lastest follow up elbow function was assessed according to standardized questionnaires and classification systems.
  
  
  RESULTS
  All six patients healed their osteotomies. Three patients had a postoperative complication which were treated succesfully. Range of motion improved significantly and all patients were satisfied with the outcome. The elbow performance scores were good to excellent in all. Correlation analyses showed that age and level of osteoarthritis are very strong predictors for the long-term elbow function and quality of life.
  
  
  CONCLUSIONS
  An intra-articular corrective osteotomy for a malunited distal humerus fracture is a worthwhile procedure. Based on our results it should particularly be considered in young patients with minimal osteoarthritis and moderate to severe functional disability and/or pain.
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kinaci
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Geert A
authors.initials: GA
authors.lastname: Buijze
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Diederik H van
authors.initials: DH
authors.lastname: Leeuwen
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Jupiter
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Rene K
authors.initials: RK
authors.lastname: Marti
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kloen
keywords: Distal humerus fracture; Distal humerus malunion; Intra-articular corrective osteotomy; Long-term follow-up