Surgical treatment and functional outcome of open supraintercondylar fractures of the humerus

This is a retrospective study of the functional outcome of Orthopedics Trauma Association Type C open distal humerus fracture treated by posterior triceps splitting approach. There were 10 patients with mean age of 50 years (18-76 years). Two C1, five C2, and three C3 open fracture were included in this study. Nine patients were treated with open reduction and fixation with posterior double plate and one was treated with a single plate and multiple Kirchner wire fixations by posterior tricep splitting approach. The mean casting period was 5-8 weeks for C3 fracture and the period of long arm splint was 4 weeks for C1 and C2 fractures. The mean follow-up period was 34 months. Eight patients were operated within 6 hour after injury and one was delayed for 2 days and another for 3 days because of severe swelling and poor general condition. Functional outcome was evaluated by Mayo elbow performance score. The mean score was 81.5 point (standard deviation 9.4). Seven patients had good to excellent result and three patients had fair result. Mean elbow range of motion was 81°. Complications included two superficial wound infection and two nonunion. Neither implant failure nor ulnar nerve injury nor heterotopic ossification was noted during this follow up period. Two patients had delayed operation 2-3 days after stabilizing other associated injury. Immediate open reduction and internal fixation of open intra-articular fracture of the distal humerus is a safe and effective technique with a low rate of infection and complications.