DISTALE HUMERUSFRAKTUREN

Abstract

There are no unanimous opinions concerning therapeutic guidelines for the treatment of distal intra-articular comminuted fractures of the humerus. Many surgeons tend toward a conservative procedure since osteosynthesis with stable movement is often difficult or impossible to achieve if many fragments are present. With increasing experience on the part of the surgeon and improvements both in the instrumentarium and the surgical techniques, improved results may be expected even with this type of fracture because of the possibilities for the reconstruction of the joint and early mobilization. In a comprehensive statistical study conducted by the German section of AO International, 182 patients who were surgically treated for elbow fractures according to the principles of the AO were reexamined. The results show that maximum results, namely, a complete anatomic and, above all, functional restoration of the joint could be achieved in only a few cases. The extent of the remaining disability can, however, be controlled in 2/3's of the cases to such an extent that no alterations were necessary in private or professional life. 27.5% of the results could be classified as very good, an additional 39.6% as good, 21.4% as moderate and 11.5% as poor. The breakdown of injuries, surgical procedures, follow-up treatment and results in this relatively large number of cases permits a few conclusions and, therefore, justifies drawing up appropriate guidelines for the treatment of distal intra-articular fracture of the humerus.