Effects of surgical approach on functional outcomes of open reduction and internal fixation of intra-articular distal humeral fractures: A systematic review

摘要

Fractures of the distal humerus are uncommon injuries, constituting between 0.5% apd 7% of all fractures and 30% of all elbow fractures.2'15 Up to 96% of these injuries are intercondylar, or АО type C, distal humeral fractures involving the articular surface.29 These fractures afe notoriously difficult to treat, presenting the surgeon with multiple challenges including the complex anatomy of the elbow joint itself, articular surface comminution, and frequently, osteopenic or osteoporotic bone stock.41 Anatomic reduction of the joint surface, restoration of the overall anatomic axes of the extremity, and stable fixation allowing for early elbow mobilization are keys to achieving a good surgical outcome.9'16 Early motion is critically important after open reduction and internal fixation (ORIF) of these fractures32 because the elbow joint capsule is very prone to scarring, and immobilization past 3 weeks has been linked with poorer outcomes.