The internal fixation for severe comminuted intercondylar fractures of humerus / 中华创伤骨科杂志

ABSTRACT

Objective To discuss relative factors of successful internal fixation for humeral comminuted intercondylar fractures. Methods 18 cases of humeral comminuted intercondylar fracture were treated with operation form March 1998 to March 2002. According to AO Classification, there were 10 cases of type C2, and 8 cases of type C3. The fractures were approached through tongue of triceps in 6 cases, through osteotomy of olecranon in 10 cases, and through fracture of olecranon in 2 cases. In the group of type C2, the fixation with intercondylar screw and 2 plates (AO reconstruction plate and one third tubular plate) was done in 10 cases, and with intercondylar screw and AO reconstruction plate in 2 cases. In the group of type C3, the fixation with intercondylar screw and 2 plates was done in 5 cases, with intercondylar screw and AO reconstruction plate in 1 case, and screw and kirschner wire in 2 cases. Results 18 cases were followed up from 8 months to 63 months, averaging 38 months. They were evaluated with modified Cassebaum rating system. 8 cases were rated as excellent, 5 as good, 3 as fair, and 2 as poor. Conclusions Early operation, anatomical reduction, rigid fixation and early exercise are the key factors of a successful treatment. The first choice of approach is osteotomy of olecranon.