THE EFFECT OF ASSOCIATED INJURIES ON THE OUTCOME OF PATIENTS WITH DISTAL HUMERAL FRACTURES

Abstract

This study was designed to answer the question “Is there a difference in outcome following operative management of AO type C distal humerus fractures for patients with associated injuries compared to those with isolated injuries?” Our hypothesis was that patients with associated injuries would have worse outcomes compared to those with isolated injuries.

Fifty-eight patients with fifty-eight fractures managed with ORIF were included. Hospital records, clinic notes and radiographs of these patients were retrospectively reviewed. MFA and DASH scores were prospectively obtained after patients were identified (mean 37.4 months post injury, range 6–74 months).

Thirty-two patients had isolated distal humeral fractures while twenty-six patients had distal humeral fractures with associated injuries. The mean MFA of patients with isolated injuries was significantly lower than for patients with associated injuries (27.2 vs 41.7, p = 0.01). There was no difference in DASH scores between the two groups (23.7 vs 29.1, p = 0.34). The mean postoperative arc of motion was one hundred and seven degrees for isolated injuries and seventy-five degrees for patients with associated injuries (p=0.006). Surgical release for stiffness was required for two patients (6%) in the isolated group and ten patients (38%) in the associated injuries group (p=0.003).

Outcomes for isolated distal humeral fractures in this study were comparable to previously published literature. Patients who sustain associated injuries at the time of distal humeral fracture have more stiffness and a worse outcome on a global outcome score, but a similar outcome on a limb specific outcome score.