O2524 THE TREATMENT AND FUNCTIONAL OUTCOME OF TYPE IV CORONAL SHEAR FRACTURES OF THE DISTAL HUMERUS: A RETROSPECTIVE REVIEW OF FIVE CASES

Abstract

Aims: To present the treatment method and outcome of þve cases of type IV coronal shear fractures of the distal end of the humerus. Methods: In a two year period, þve patients with an isolated type IV coronal shear fracture of the distal end of the humerus underwent open reduction and internal þxation of the fractures utilizing Herbert screws, through a modiþed extensile lateral Kocher approach. The main outcome measurements were: Functional elbow index rating scale of Broberg- Morrey, Mayo Elbow Performance Score, subjective satisfaction rate and subjective functional limitations, and radiographic evaluation. Results: The follow-up time ranged from thirty nine to þfty months. All fractures healed within a range of six to nine weeks. The latest radiographic evaluation revealed mild degenerative joint disease changes in one patient and osteonecrosis of the coronal shear fragment in another. None of the patients reported pain even during strenuous activities, and none had clinical þndings or subjective complaints suggesting instability of the elbow joint. Four patients regained full range of elbow motion as compared with the contralateral elbow, and only one had a 10û extension lag. No patient reported limitations in activities, and all indicated complete satisfaction with their outcome. According to the Broberg Morrey Scale and the Mayo Elbow Performance Score, all results were excellent, with the scores ranged from 98 to 100 points. Conclusions: Recognition of this particular type of injury, prompt treatment with anatomic reduction and internal þxation, and early rehabilitation can lead to excellent functional outcomes.