EVALUATION OF FUNCTIONAL OUTCOME AFTER TREATING DISTAL HUMERUS FRACTURES WITH THE ANGULAR-STABLE 2,4/3,5 MM LCP DISTAL HUMERUS PLATE SYSTEM USING THE MAYO ELBOW PERFORMANCE SCORE.

Abstract

Patients and Methods: Between December 2005 until January 2008 34 distal humerus fractures in 33 patients were prospectively documented and treated using the angular-stable LCP distal humerus plate system from Synthes/Switzerland. Patient median age was 54 (min 14/ max 88). Fracture types were classified according to the AO classification. Extraarticular A fractures were documented in 3 (9%) cases, partial intra-articular fractures (type B) were seen in 4 (12%) patients. Complete intraarticular fractures were found in 27 (79%) cases. Three fractures were grade I° open, 6 fractures were grade II° open according to the Gustilo classification. In median after 10 months (min 8/ max 20) follow up was performed. Due to lost to follow up in one patient functional outcome was measured in 32 patients. Functional results were evaluated using the Mayo Elbow Performence Score (MEPS).

Results: According to MEPS, predominantly excellent and good results were achieved. The intent of stable fracture fixation to allow early physical therapy was reached in 31 patients. Failure of osteosynthesis making operative revision necessary occurred in 3 patients (1x implant failure, 2x loss of reduction). Mean Mayo Elbow Performance Score was 91 points (min 88.5/ max 100). Mean range of motion for extension/flexion was 110° (min 80/ max 140) and 170° (min 125/max 180) for pronation/supination. Only one patient regained unrestricted extension, mean loss of extension was 21° (min 10/ max 40). Mean Flexion up to 131° was achieved (min 125/ max 140).

Postoperative complications were seen in eight cases (implant breakage, delayed union, lost of reduction).

Conclusion: Despite postoperative complications and revision surgery, functional results achieved using the angular-stable LCP distal Humerus system are good or excellent in the majority of patients. Through angular-stable and multidirectional screw options fixation of the distal fragment is sufficient and periostal blood supply could be protected. Especially in combination of intraarticular fractures and osteoporotic bone stock the use of the LCP distal Humerus plate system is suitable and permits early physical therapy, promising a benefit for the elbow function.