Evaluation of the Results of Open Reduction and Internal Fixation of Intercondylar Fracture of Distal Humerus in Adult by Lateral Condylar Locking Plate and Medial Condyle by Tension Band Wiring

Background: The present prospective study was conducted to evaluate the functional outcomes of open reduction and internal fixation of Intercondylar fractures of the distal humerus in adultsby lateral condylar locking plate and medial condyle by tension band wiring.
Methods:This study was conducted at NITOR over a period of two years. A total of 12 patients over 18 years irrespective of sex was included in this study. Only intra-articular fractures of distal humerus (Riseborough and Radin, 1996) type- III were included in this study. Patients with open fracture, fractures more than 3 weeks old and children’s fractures were excluded from this study. This prospective study was carried out with an aim to evaluate the functional outcome of open reduction and internal fixation of intercondylar fractures of distal humerus in adults using lateral condylar locking plate and medial condyle by tension band wiring through extra-articular olecranon osteotomy approach within 3 weeks of incidence were enrolled in this study, who were admitted in National Institute Of Traumatology and Orthopedic Rehabilitation (NITOR) over a period of 2 years from January 2012 to December 2013.
Results: Out of 12 patients 1 patient (8.33%) was aged below 20 years, 8 (66.67%) aged 21-40 years and the rest 3 (25.0%) aged >40 years. Mean±SD was 32.50±6.40 and range 18-50 years. Out of 12 patients, 8 (66.67%) patients were male and 4 (33.33%) were female. Out of 12 study patients 2(16.67%) were housewives, 1(8.33%) businessman, 3(25%) service holder, 2(16.67%) student, 1(8.33%) farmer and 3 (25%) day labour. Out of 12 study patients distal humeral fracture in right upper limb 7(58.33%) and left upper limb 5(41.67%). Out of 12 patients, time gap between injury and operation was< 1 week in 9(75%) and > 1 weeks in 3 (25%) patients. Mean interval between injury and operation is 6 days with SD ±4.24.Out of 12 study patients, superficial infection was found in 2 (16.66%) and K-wire loosening in 1 (8.33%).On the final follow up 11(91.66%) patients had no limitation of performing comb hair and the rest 1(08.33%) had difficulty in performing comb hair. On the final follow up 91.66% of the patients could maintain personal hygiene and 08.33% could not maintain. On the final follow up 11(91.67%) of the patients had no limitation of wearing shirt /blouse and 1 (08.33%) of the patients had limitation. Out of 12 study patients, no pain was found in 11 (91.67%) patients and mild pain was found in 1 (8.33%) patient. According to Mayo Elbow Performance Scoring criteria the arc of motion of elbow was >1000
in 10(83.34%) patients, arc (50 to 100)0
in 2(16.66%) patients and motion arc < 500
in 0 (0%) patient. Finally, excellent result was found 11 (91.67%)& good result was found 1 (08.33%)of the study patients.

Conclusion:According to Mayo Elbow Performance Score, excellent and good outcome were considered as satisfactory & fair and poor outcome is considered as unsatisfactory. All 12 patients achieved satisfactory outcomes. No patient had an unsatisfactory outcome.