The Treatment For Type C Distal Humeral Fracture By Approach Of Olecroanon V Osteotomy Approach With Double Plate

[Objective]:To study the outcome for the treatment of fracture distal end humerus with AO double plate and to analyze the factors that influence the recovery of elbow function after operation.[Methods]:18 cases of comminuted distal humural fracture were operated from March, 2008 to December,2009. (Male,14, female,4, aged from 18 to 60 years, owerage 36.4 years. Seven cases at the left side, and 11 cases at the right side.) Based on AO/ASIF, C1:6, C2:10, C3:2. There are two open fractures and one neurological deficits. All cases adopted chevron osteotomy of the olecranon approach and internal fixation with AO bi-plate. Passive functional exercise of elbow was done as early as possible after operation or under the CPM, and active functional exercise was also done as early as possible.[Results]:18 cases were followed-up for 8 to 19 months (mean 14),17 cases of fracture healed. Post-operative complications:wound infection (1 case, change medicine for 3 weeks and then heal); ulnar nerve injury (1 case, fingers can move but numb in the ring finger and little finger. Symptoms disappeared after operation by effective treatment for 6 to 8 weeks); one case did not heal until bone grafts were operated twice. According to the Jupiter elbow grading standard, the results were excellent in 12 cases, good in 4 cases and ok in 2 cases. The perfect rate was 89%[Conclusion]:Nowadays, chevron osteotomy of the olecranon with AO bi-plate is a better way to treat distal humeral fracture of type C. The severity of the fracture, the soft tissue injury, effective restoration during the operation, rigid internal fixation, early time function exercise and so on, are the major factors, which will affect the recovery of elbow function.