DOI: http://dx.doi.org/10.18203/2349-2902.isj20220316

Results of surgical treatment of distal humerus fractures in adults in Cotonou

S. Pascal Chigblo, Gaspard D. Gbessi, Francois Amossou, Adebola Padonou, I. Fiacre Tidjani, Eric Lawson, Oswald Goukodadja, Aristote A. Hans-Moévi

Abstract


Background: Fractures of the distal humerus represent 1.3% of fractures in Cotonou. Their treatment is often surgical. The aim of this work was to assess the results of their osteosynthesis in a disadvantaged environment.

Methods: This retrospective study from 2001 to 2015 included 38 operated patients for distal humerus fracture with a minimum follow-up of 12 months. The average age was 33.6 years; the predominance was male (27 cases). The major etiology was traffic accidents (31 cases), According to the AO classification, the fractures were type A (10 cases), type B (02 cases) and type C (26 cases). The average time of surgery was 21 days. The Lecestre plate was the most used (29 cases). An iliac cortico-cancellous graft was used in 03 cases. The mean hospital stay was 20 days.

Results: The mean follow-up was 37 months. Functionally, the mean Mayo elbow performance score (MEPS) score was 66.3 points. The results were excellent (08 cases), good (13 cases), average (10 cases) and bad (7 cases). The patients were satisfied or very satisfied in 29 cases. Radiographically, the reduction was anatomical in 34 cases. Anatomical reductions were obtained with Lecestre plates. Consolidation was achieved in 36 cases within an average of 9 weeks. As complications we noted: radial nerve paresis (03 cases); secondary displacement (02 cases); superficial infection of the operating site (02 cases), wire migration or screw retraction (05 cases), non-union (03 cases), malunion in varus (04 cases) and osteitis of the proximal ulna (01 case).

Conclusions: Fractures of the distal humerus are infrequent. The anatomical and functional results despite little technical support provided and the long delay before surgery are quite good.


Keywords


Fracture, Distal humerus, Osteosynthesis, Results

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References


Waota AC, Guedegbe F, Monsia A, Kone M, Douane G. Les fractures récentes de la palette humérale chez l'adulte. Variétés anatomiques et indications thérapeutiques, à propos de 15 cas. Rev méd Côte d'Ivoire. 1984;18:6-12.

Sané AD, Dakouré PWH, Diémé CB, Kinkpé CVA, Dansokho AV, Ndiaye A, et al. L’ostéotomie de l’olécrâne dans le traitement des fractures de la palette humérale de l’adulte : évaluation anatomique et fonctionnelle du coude à propos de 14 cas. Chir Main. 2009;28:93-8.

Sané AD, Dieme CB, Keita I, Coulibaly-Ndiaye NF, Ndiaye A, Seye SIL. Traitement des fractures de l’extrémité distale de l’humérus chez l’adulte. A propos de 36 cas. Méd afr Noire. 2009;5602:65-8.

Judet T. Fractures de l'extrémité inférieure de l'humérus de l'adulte. Conf d'enseignement Paris, Expansion scientifique française. 2000;73:81-90.

Charrissoux Jl, Marcheix PS, Mabit C. Fractures de l’extrémité distale de l’humérus : techniques chirurgicales. EMC –Techniques chirurgicales- Orthopédie – Traumatologie. 2013;8(4):1-11.

Lecestre P, Aubanial JM, Claisse PR. Les fractures de l'extrémité inférieure de l’humérus chez l'adulte. Table ronde de la SOFCOT Rev Chir Orthop. 1980;66:21-50.

Charissoux JL, Mabit C, Fourastier J, Beccari R, Emily S, Cappalli M, et al. Fractures articulaires complexes de l’extrémité distale de l’humérus chez le sujet âgé. Rev Chir Orthop. 2008;94:36-62.

Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of internal fixation. Technique recommended by the AO group (2nd ed). Springer Verlag. New York. 1979.

Chigblo P, Lawson E, Tidjani IF, Padonou A, Nézien CT, Goukodadja O, et al. Epidemiology of fractures in a tropical country. Eur Scientific J. 2017;13(24):416-26.

Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-7.

Ouzaa MR, Bennis A, Zaddouk O, Zine A, Tanane M, Benchakroun M, et al. Les fractures de la palette humérale : a propos de 45 cas. PAMJ - Clinical Medicine. 2020;4:84.

Ducrot G, Bonnomet F, Adam P, Ehlinger M. Traitement des fractures de l’humérus distal par plaque verrouillée LCP DHP™ chez les sujets de plus de 65 ans. Rev Chir Orthop. 2013;99:112-21.

Clavert P, Ducrot G, Sirveaux F, Fabre T, Mansat P, SOFCOT. Outcomes of distal humerus fractures in patients above 65 years of age treated by plate fixation. Orthop Traumatol Surg Res. 2013;99:771-7.

Proust J, Oksman A, Charissoux JL, Mabit C, Arnaud JP. Résultats de l’ostéosynthèse des fractures articulaires de la palette humérale chez le sujet âgé. Rev Chir Orthop. 2007;93:798-806.

Obert L, Ferrier M, Jacquot A. Complications du traitement des fractures de l’humérus distal du sujet de plus de 65 ans. Rev Chir Orthop. 2013;99:745-50.

Manueddu CA, Hoffmeyer P, Haluzicky M, Blanc Y, Borst F. Fractures de la palette humérale chez l'adulte: évaluation fonctionnelle et mesures de forces isométriques. Rev Chir Orthop. 1997;83:551-60.

Institut National de la Statistique et de l’Analyse Economique (INSAE) Population béninoise. Available at: https://www.insae-bj.org/statistiques/ indicateurs-recents/43-population. Accessed on 26 February 2019.

Elhage R, Maynou C, Jugnet PM, Mestdagh H. Résultats à long terme du traitement chirurgical des fractures bicondyliennes de l'extrémité distale de l'humérus chez l'adulte Chir main. 2001;20:144-54.

Caja VL, Moroni A, Sabato C, Vendemia V, Sábato C, Zinghi G. Surgical treatment of bicondylar fractures of the distal humerus. Injury. 1994;25:433-43.