A Prospective Study on Functional Outcome of Adult Type C Distal Humeral Fractures with Bicolumnar Fixation

In young adults, most distal humerus fractures occur from high- energy trauma, sideswipe injuries, motor vehicle accidents, fall from height and gunshot wounds. In elderly persons with more osteoporotic bone most of these injuries occur from trivial falls. Surgeons who treat fracture of the distal humerus frequently have realized the challenges that arise related to poor bony quality, distal separation of the articular fragment from the columns of the distal humerus and fragmentation of the articular surface in one or more Even minor irregularities of the joint surface of the elbow usually cause some loss of function. Surgical treatment for these fractures has evolved significantly in the last 30 years. In the 1960�s and 1970s, most surgeons condemned surgical treatment due to high failure rates with loss of fixation, non union and elbow stiffness.1 In the 1970s, treatment began to shift from casting and the �bag of bones� technique to surgical intervention with limited internal fixation. Again, results generally were poor due to lack of adequate stabilization for early motion. In the early 1980s, the AO-ASIF group reported good and excellent results in 27 of 39 patients with comminuted fractures of the distal humerus. These by far were the best results reported in the treatment of these difficult fractures at that time. This led to an increased enthusiasm for surgical reduction and fixation.