Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction
Background: Open complete articular injuries of this distal humerus are rare injuries which are challenging to manage. The study unit aims to present a small case series of Gustilo-Anderson type III open complete articular fractures which have undergone a single-stage definitive fixation and soft-ti...
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Elsevier
2021-08-01
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Series: | JSES Reviews, Reports, and Techniques |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639121000183 |
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author | Khalid Al-Hourani, MRCS Alistair Jones, FRCS Hashim Al-Musawi, MRCS Michael B. Kelly, FRCS |
author_facet | Khalid Al-Hourani, MRCS Alistair Jones, FRCS Hashim Al-Musawi, MRCS Michael B. Kelly, FRCS |
author_sort | Khalid Al-Hourani, MRCS |
collection | DOAJ |
description | Background: Open complete articular injuries of this distal humerus are rare injuries which are challenging to manage. The study unit aims to present a small case series of Gustilo-Anderson type III open complete articular fractures which have undergone a single-stage definitive fixation and soft-tissue coverage, presenting their functional outcomes. Methods: Retrospective case series identifying all type IIIB AO 13-C3 distal humeral fractures from the unit trauma database. The primary outcome was the Oxford Elbow Score. Secondary outcomes included deep infection, nonunion, and reoperation. Results: A total of six patients were identified, (four open type IIIA, 2 type IIIB). All patients underwent single-sitting definitive fixation and soft-tissue coverage. Mean range of motion arc was 90 degrees. The median Oxford Elbow Score was 35 (range 21-43), representative of mild to moderate arthritis. One patient (n = 1) developed deep infection at 24 months and required reoperation. All patients (n = 6) proceeded to union at the latest follow-up. We present a case report of a 59-years-old patient who sustained a type IIIB, AO 13-C3 distal humeral fracture who underwent single-sitting definitive fixation and flap coverage. Conclusion: This case series reports that positive functional outcomes representative of mild/moderate arthritis at short to midterm follow-up can be achieved after definitive fixation and soft-tissue coverage in a single sitting, including when the soft tissue is deficient. This is a rare injury which is under-reported in the literature. |
first_indexed | 2024-12-16T18:10:51Z |
format | Article |
id | doaj.art-805829b4e8ed45b090ad7ea7c9077925 |
institution | Directory Open Access Journal |
issn | 2666-6391 |
language | English |
last_indexed | 2024-12-16T18:10:51Z |
publishDate | 2021-08-01 |
publisher | Elsevier |
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series | JSES Reviews, Reports, and Techniques |
spelling | doaj.art-805829b4e8ed45b090ad7ea7c90779252022-12-21T22:21:47ZengElsevierJSES Reviews, Reports, and Techniques2666-63912021-08-0113286290Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstructionKhalid Al-Hourani, MRCS0Alistair Jones, FRCS1Hashim Al-Musawi, MRCS2Michael B. Kelly, FRCS3Department of Orthopaedic Surgery, The Royal Infirmary of Edinburgh, Edinburgh, UK; Corresponding author: Khalid Al-Hourani, MRCS, Department of Trauma & Orthopaedics, The Royal Infirmary of Edinburgh, 47 Little France Crescent, EH16 4SA Edinburgh, UK.Department of Orthopaedic Surgery, Southmead Hospital, Bristol, UKDepartment of Orthopaedic Surgery, Southmead Hospital, Bristol, UKDepartment of Orthopaedic Surgery, Southmead Hospital, Bristol, UKBackground: Open complete articular injuries of this distal humerus are rare injuries which are challenging to manage. The study unit aims to present a small case series of Gustilo-Anderson type III open complete articular fractures which have undergone a single-stage definitive fixation and soft-tissue coverage, presenting their functional outcomes. Methods: Retrospective case series identifying all type IIIB AO 13-C3 distal humeral fractures from the unit trauma database. The primary outcome was the Oxford Elbow Score. Secondary outcomes included deep infection, nonunion, and reoperation. Results: A total of six patients were identified, (four open type IIIA, 2 type IIIB). All patients underwent single-sitting definitive fixation and soft-tissue coverage. Mean range of motion arc was 90 degrees. The median Oxford Elbow Score was 35 (range 21-43), representative of mild to moderate arthritis. One patient (n = 1) developed deep infection at 24 months and required reoperation. All patients (n = 6) proceeded to union at the latest follow-up. We present a case report of a 59-years-old patient who sustained a type IIIB, AO 13-C3 distal humeral fracture who underwent single-sitting definitive fixation and flap coverage. Conclusion: This case series reports that positive functional outcomes representative of mild/moderate arthritis at short to midterm follow-up can be achieved after definitive fixation and soft-tissue coverage in a single sitting, including when the soft tissue is deficient. This is a rare injury which is under-reported in the literature.http://www.sciencedirect.com/science/article/pii/S2666639121000183OpenDistalHumerusFunctionalOutcomesOrthoplastic |
spellingShingle | Khalid Al-Hourani, MRCS Alistair Jones, FRCS Hashim Al-Musawi, MRCS Michael B. Kelly, FRCS Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction JSES Reviews, Reports, and Techniques Open Distal Humerus Functional Outcomes Orthoplastic |
title | Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction |
title_full | Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction |
title_fullStr | Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction |
title_full_unstemmed | Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction |
title_short | Type III open complete articular fractures of the distal humerus: case series outcomes after orthoplastic reconstruction |
title_sort | type iii open complete articular fractures of the distal humerus case series outcomes after orthoplastic reconstruction |
topic | Open Distal Humerus Functional Outcomes Orthoplastic |
url | http://www.sciencedirect.com/science/article/pii/S2666639121000183 |
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