Surgical result of distal humerus fractures in adults: A consecutive series of 55 cases and review of the literature

Abstract

Introduction: Fractures of the humeral pallet are more and more frequent; this is linked to the increase in road accidents and their violence. Methods: We have collected in our archives 55 cases of fracture of the humeral pallet at the Traumatology–Orthopedics Department of the IBN SINA CHU in RABAT from January 2015 to December 2019. Results: They mainly affect young adults with a clear predominance of men (73%). The trauma most often occurs by direct mechanism (65%). The main cause of these fractures is represented by road accidents (56%), followed by assaults and falls. Supra and intercondylar fractures are the most described anatomical form (65%). The treatment is surgical in all cases, with predominance of the posterior approach. Discussion: Considering the comminution often encountered, only a solid and stable osteosynthesis allows the anatomical restoration of the elbow, by adapting the indications to the types of fractures and by using a more codified technique, to allow an early rehabilitation, better guarantee of recovery of elbow function. The LECESTRE premolded plate is the most used in supra and intercondylar fractures; it seems to be a real progress in osteosynthesis (31.03% good results and 51.72% average results) for this type of fracture. Conclusion: The management of humeral paddle fractures is based on perfect anatomical reduction, by a solid assembly which must allow early rehabilitation ensuring good functionality. Level of Evidence: IV-retrospective study.