Functional Outcome Of Distal End Humerus Fracture Fixed By Dual Plating

Abstract

Background: Intra-articular distal humerus fractures are rare but complex injuries that present major surgical challenges. Stable fixation and early mobilisation are essential to avoid stiffness and restore elbow function. Dual plating has emerged as the standard of care, but evidence from Indian centres remains limited.

Methods: This prospective study included 20 adult patients (≥18 years) with closed intra-articular distal humerus fractures (AO/OTA Type B and C) treated with dual plating at a tertiary care centre between February 2023 and February 2025. The posterior approach was used in 70% of cases, while olecranon osteotomy was required in 30%. Patients underwent structured rehabilitation with early mobilisation. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS) at 6 weeks, 12 weeks, and 6 months. Radiological union and complications were documented. Statistical analysis employed one-way ANOVA for MEPS progression and Chi-square testing for AO type versus outcome.

Results: The mean age was 46.5 years, with 55% males. AO Type B fractures accounted for 55% and Type C for 45%. Mean MEPS improved from 68.2 at 6 weeks to 84.3 at 6 months (p < 0.001). At 6 months, 30% achieved excellent, 40% good, 20% fair, and 10% poor outcomes. Union was achieved in 90% of patients within a mean of 14.4 weeks. Complications included infection (20%), delayed union (15%), non-union (10%), implant failure (10%), and transient nerve palsy (10%). No significant association was found between AO type and functional outcome (p = 0.758).

Conclusion:Dual plating for intra-articular distal humerus fractures provides stable fixation, high union rates, and satisfactory functional outcomes irrespective of fracture type. Early rehabilitation remains crucial to optimise recovery.