Outcomes following distal humeral fracture fixation with an extensor mechanism-on approach

Jason M. Erpelding, Adam Mailander, Robin High, Matthew A Mormino, Edward V. Fehringer

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Distal humeral fractures have traditionally been managed with surgical approaches that disrupt the extensor mechanism. We hypothesized that an extensor mechanism-on approach for operative fixation of distal humeral fractures with parallel or orthogonal plate constructs would allow excellent healing, a motion arc of the elbow exceeding 100°, and maintenance of extensor mechanism strength. Methods: Distal humeral open reduction and internal fixation (ORIF) was performed with either orthogonal or parallel plate constructs in seventy-nine elbows. Thirty-seven elbows were fixed via an extensor mechanism-on surgical approach, and twenty-four of them were available for additional evaluation. Radiographs as well as MEPI (Mayo Elbow Performance Index), DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores were obtained. Results: All thirty-seven fractures healed primarily. Three elbows underwent later release because of stiffness. The median arc of elbow motion was 126° (range, 60° to 141°). The mean MEPI was 91.5 points and the mean DASH score was 15.9 points, indicating excellent scores with mild impairment. The median percent loss of triceps strength was 10% (range, 0% to 49%) compared with the contralateral, normal elbow. Conclusions: Open treatment of distal humeral fractures with an extensor mechanism-on approach results in excellent healing, a mean elbow flexion-extension arc exceeding 100°, and maintenance of 90% of elbow extension strength compared with that of the contralateral, normal elbow. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)548-553
Number of pages6
JournalJournal of Bone and Joint Surgery - Series A
Volume94
Issue number6
DOIs
StatePublished - Mar 21 2012

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Humeral Fractures
Fracture Fixation
Elbow
Arm
Hand
Maintenance

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Outcomes following distal humeral fracture fixation with an extensor mechanism-on approach. / Erpelding, Jason M.; Mailander, Adam; High, Robin; Mormino, Matthew A; Fehringer, Edward V.

In: Journal of Bone and Joint Surgery - Series A, Vol. 94, No. 6, 21.03.2012, p. 548-553.

Research output: Contribution to journalArticle

Erpelding, Jason M. ; Mailander, Adam ; High, Robin ; Mormino, Matthew A ; Fehringer, Edward V. / Outcomes following distal humeral fracture fixation with an extensor mechanism-on approach. In: Journal of Bone and Joint Surgery - Series A. 2012 ; Vol. 94, No. 6. pp. 548-553.
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