Anterior Elbow Approach And Internal Fixation For Treatment Of Transarticular Shear Fractures Of The Distal Humerus In Adults

Objective: To evaluate the clinical result of anterior elbow approach and internalfixation for treatment of transarticular shear fractures of the distal humerus in adults.Methods: From September2006to September2011,12patients of9males and3females capitulum humeri fractures were chosen anterior approaches of elbow.Thefractures were treated with under direct vision and were fixde with screws.The left armsin5,right in7,the age of the group were from17to61years old,with the average of38years.The operative time was form2to8days after injury.They were fresh and closefractures. All the fractures were classified into type IA(4cases),type1B(1ease), type2A(2case), type3A(1cage)and type3B(4eases)according to Dubberleyclassification.Under the direct vision,cannulated screw was used after anatomicreduction was confirmed by fluoroscopy.Results: AIl fractures were reduced anatomically without any neural or vascularinjury, were found1—3years postoperatively.There were excellent in8cages.and goodin4cases.The average Broberg-Morrey score was94.58.The average src offlexion-extension was125.83°.As to the4cases with posterior comminution.theaveraged score and the arc of flexion-extension was92.8and104°,respectively.Displace of capitulum-trochlea hemeri does not link with muscle and capsulaarticularis,blood carries supply.Without avasular nectosis probably ocdurs at fairstage.The close manipulation of capitulum humeri fractures hardly succeeds.Thetreatment with accurate open reduction associated with strong fixation can decrease therate of avascular necrosis in the capitulum humeri fractures.Conclusion: The capitulum humeri fractures are suitable for opening reduceddirect vision and fixing with screws through anterior approaches of the elbow.The patients were encouraged to proceed for active rehabiliation early such as the elbowflexion-extension.Its clinical outcomes is xcellent.