Coronal Plane Articular Shear Fractures of Distal Humerus: Surgical Technique and Functional Outcome

Background: The objective is to outline the surgical technique pertaining to different fracture patterns and their outcomes. Material and Methods: A total of 7 patients with capitellum or trochlea or both were enrolled in the study. All patients were subjected to relevant investigations after which were taken up for surgical fixation with headless compression screw and if associated with posterior column involvement distal humerus plates were used. Depending on the fracture classified by dubberly et al surgical approaches either lateral kocher’s approach or posterior approach with olecranon osteotomy is used. Results: A total of 7 patients coronal shear fracture of distal humerus underwent surgery. The outcome is assessed using Mayo Elbow Performance Score[MEPS]. Cases were followed up for 12 to 24 months (avg. 18 months). Postoperative Flexion-Extension Arc, Forearm rotation Arc and MEPS score are 135±10, 169.2±8.2 and 85±10. Average Time of union is 9±2 weeks. For Type 1 fractures union time was 7-8 weeks, for Type 2 & 3 fractures union time was 9-11 weeks. Conclusion: Utilising a lateral approach Headless compression screws can be used to treat capitellum and trochlea fractures, with satisfactory functional outcomes. Posterior approach using olecranon osteotomy can be used for type 3b fracture patterns.

Keywords: Capitellum, trochlea, distal humerus, coronal shear fractures, headless compression screws.