Backgropnd: In elderly patiehts the tolerance ojelbow joint to immobilization is very poor and stiffness develops easily. so conservative treatment is not suitable method Jor intraarticularfractures oj the distal humerus. Although open reduction and internalfixation is the treatment oj choice for these fractures in adults, in elderly patients disagreement remains on how to treat thesefractures. Also the reports on the Junctional results aJter internal fixation oj these Jractures in elderly patients are rare.
Objectives: The purpose ofthis study is to evaluate the results ojopen reduction and stable internalfixationJor treatment oj intra-articularfractures ojdistal humerus in elderly patients above 60 years old.
Patients and Methods: 10 patients with 10 intra-articularJractures ojdistal humerus. The average age was 63 years {ranged 60-73 years}. There were sexJemales {60%} andJour male (40%). The right side was ajI
Jected in seven patients (70%) and leJt side in three patients (30%). The
Jractures were classifIEd according to the AO/ASIF classifICation. There
was onefracture (1 O%) type B 1, Jourfractures (400h) type C1, threefractures
(30%) type C2 and two Jractures (20%) type C3. All the patients
were treated by open reduction and internalfixation through a posterior
approach. The average Jollow up period was 18 months (ranged 12-32
months) During it the patients were examined both clinically and radiographically
Jor union oj the fractures. Post-traumatic arthritis, range oj
motion the elbow andJorearm, muscle strength. degree ojpain. return to
previous activities. The final results were evaluated according to the
Mayo Elbow scoring points ~ystem.. ·Results: auerage time to unioll. were 3.5 .months (ranged 24.5mbnthS);'Four patients (40%) had Post-traumatic arthritis oj the elbow three patients with mild degree and one patient with severe degree). The motion at the elbow was mainly affected, the median arc of jlexi.JJn/ extension was 1000 (ranged 600-1300). Theforearm motion was not ajjected and it was near normal in all ojthe cases. The final clinical results were excellent in three patients (30%). good infive patients (50%), jair in one patient (10%). and poor in one patient (10%).
Conclusion: Open reduction and internalfixation ojdistal humeral intra-articularfractures in elderly patients can achieve excellent and good results in majortty ojthe patien.ts. Advancing age is not a contraindication jor open reduction and internalfIXation ojthesefractures. |
