ZLOMENINY DISTÁLNÍHO HUMERU U PACIENTŮ STARŠÍCH ŠEDESÁTI LET
| Title in English | DISTAL HUMERUS FRACTURES IN PATIENTS OLDER THAN AGE 60 |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Úrazová chirurgie |
| MU Faculty or unit | |
| Citation | |
| Web | http://www.csuch.cz |
| Field | Traumatology and orthopaedic surgery |
| Keywords | Distal humerus fractures; plate osteosynthesis; locking compression plate; elderly patiens |
| Description | SUMMARY OBJECTIVE: A retrospective clinical evaluation of surgical treatment and complications after distal humeral fractures in patients older than age 60 treated by open reduction a internal fi xation by two plates. MATERIAL AND METHODS: Between January 2003 and December 2012 in the Traumatological hospital Brno we treated 145 patients by open reduction and internal fi xation. In 116 patients, a clinical and radiological follow up was obtained after a minimum follow up of 18 months. The age distribution was from 61 to 89 with an average of 72 years Thirty-four patients were male, eighty-two female. Fracture types were classifi ed according to the AO classifi cation. Type C fractures documented in 74 cases, type B in 38 and extraarticular fractures type A were seen in 14 cases. For all type A and C was used dorsal approach. For type B was used dorsal or lateral approach. Extraarticular olecranon osteotomy was routinely performed in type C (66 patients). The functional results were evaluated by Mayo Elbow Score. RESULTS: According Mayo Elbow Score we found 23 patients with excellent results, 44 patients with good, 34 with fair and 15 patients with poor results. An average score was 82 points (range, 43 to 100 points). The median arc of motion was 100° (range, 60 to 135°) of fl exion and extension and 110° pronation - supination (range, 60–170°). In none of the patients ankylosis of the elbow was found. Postoperative complication rate was high, predominantly seen as implant failure or screw loosening (34 patients). In this study, there were nine non-unions, including four non-unions after olecranon osteotomy, requiring revision. CONCLUSION: Management of distal humerus fractures in elderly patients is still controversy. Severe comminution, bone loss and osteopenia predispose to unsatisfactory results. Over 30 % of such fractures develop signifi - cant complications during treatment. Standard surgical techniques are used for fi xation of both columns, using a locking compression plates. |