Treatment of intercondylar humeral comminuted fractures / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate surgical treatment and curative effect of intercondylar humeral comminuted fractures.[Method]Twenty-one cases of intercondylar humeral comminuted fractures were collected from February 2001 to December 2005. The fractures were classified to 5 cases of C1,9 cases of C2 and 7 cases of C3 according to the AO classification.Seventeen fractures were internal fixed by open-reduction, and 4 fractures were treated by total elbow replacement. After olecranon osteotomy, capitate eminence and trochlea humerus were reducted and fixed with bone screw,while shaft of humerus and the distal end of humerus were fixed with AO double plate or Y-shaped plate in internal fixed group. Early physiotherapy were started as soon as possible. The elbow replacement group were replaced by semi-restriction elbow prosthesis and fixed with cemente following physiotherapy after 4 to 7 days.[Result]forteen of 17 cases were postoperatively followed-up in internal fixed group from 12 to 44 months, and all cases had been visited for 14 to 36 months in elbow replacement group. According to modified Cassebaum scoring system, 71.4% were good in internal fixed group and 100% in elbow replacement group.[Conclusion]It has good curative effect in intercondylar humeral comminuted fractures with olecranon osteotomy, the AO double plate or Y-shaped plate internal fixation and early physiotherapy. With severe injury of the distal end of humerus, obviously osteoporosis and older than 50 years, the total elbow arthroplasty and replacement are preferred.