Author(s): Dr. Pathik Vala, Dr. Ajay Devda, Dr. Darshil Parikh and Dr. Akshay Chavda

Abstract: Introduction: The management of distal humeral fractures has evolved over the last few years. In intra articular fracture of the lower end Humerus the primary goal is to achieve a stable and mobile elbow. Until now, disagreement has existed on how to treat these fractures in elderly patients. Recommendations range from conservative treatment to primary total elbow replacement. So far, reports in the literature on whether or not open reduction and internal fixation in these patients is justified are very rare. Materials and methods: Fifty four patients (Average age 45 years) from Jan 20013 To Dec 2014 were included in this series. There were 38 males and 16 females. Mechanism of injury was fall with back of elbow striking the ground (70%) and Road traffic accident (30%). The author has used AO classification5 for categorizing the fractures accordingly, 10 fractures were of B2, 14 were B3, 12 were C1 type and 10 belonged to C2 and 8 belonged to C3 Type. Results and discussion: The average follow up was 16 months with a minimum of one year. 14 cases had loss of extension measuring 300 and less. Only 12 cases had no loss of extension. Flexion of elbow more than 1200 got recovered in 28 cases. 10 patients had pain in elbow on prolonged activity and changes in weather condition. The final evaluation showed 70 % Excellent and good results, 24% had Fair results and 6% had poor results. When “K‘ wire alone were used fixation was not stable enough and required longer external immobilization. And delay in start of physiotherapy with consequent loss of movements. Olecranon osteotomy gives better visualization. and reduction of fracture fragments and their articular surface. Conclusion: Rigid Anatomical Fixation & Early Mobilisation is the Key. High complications in Elderly Osteoporotic patients. Younger the patient Better the results. Communition of Fragments show increased Difficulty in Fixation, & results in loss of movements also.

DOI: https://doi.org/10.33545/orthor.2017.v1.i2a.13