Treatment of Distal Humerus Fractures with an Extensor Mechanism-On Approach

Abstract：Objective To investigate the clinical effect of double-plating fixation in treatment of distal humerus fractures via an extensor mechanism-on approach. Methods From October 2008 to October 2010,16 patients with distal humerus frac-ture were treated with double-plating fixation via an extensor mechanism-on approach. There were 12 males and 4 females,aged from 17 to 61 years(36 years on average). The dominant extremity was involved in 11 patients. The mechanism of injury in-cluded 5 ground-level falls,9 falls from a height,and 2 motor-vehicle accidents. The fractures were classified according to the AO/ ASIF classification. 2 patients had a type-A fracture,14 had a type-C fracture. Of the type-C fractures,8 were C1,6 were C2. The time interval from the injury to surgery was two days to eight days. All patients were no preoperative ulnar nerve symp-toms. Results The 16 patients were followed-up from 12 to 24 months,with an average of 15 months. All 16 fractures healed primarily without infection. The average final flexionarc was 125°and the average flexion contracture of 23°and the average pro-nation-supination arc was 153°. The mean MEPI was 90 points(65 to 100 points),with six excellent,eight good,and two fair grades. The excellent and good rate was 87. 5% . Two patients had ulnar nerve dysfunction postoperatively. All elbows were sta-ble at the time of final follow-up. Conclusion Satisfactory functional outcomes can be acquired with the use of the extensor mechanism-on approach for AO-type-C1 and C2 fractures of distal humerus.