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...

Full description

Bibliographic Details
Main Authors: Khalid Al-Hourani, MRCS, Alistair Jones, FRCS, Hashim Al-Musawi, MRCS, Michael B. Kelly, FRCS
Format: Article
Language:English
Published: Elsevier 2021-08-01
Series:JSES Reviews, Reports, and Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666639121000183
_version_ 1818621537247297536
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
record_format Article
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
work_keys_str_mv AT khalidalhouranimrcs typeiiiopencompletearticularfracturesofthedistalhumeruscaseseriesoutcomesafterorthoplasticreconstruction
AT alistairjonesfrcs typeiiiopencompletearticularfracturesofthedistalhumeruscaseseriesoutcomesafterorthoplasticreconstruction
AT hashimalmusawimrcs typeiiiopencompletearticularfracturesofthedistalhumeruscaseseriesoutcomesafterorthoplasticreconstruction
AT michaelbkellyfrcs typeiiiopencompletearticularfracturesofthedistalhumeruscaseseriesoutcomesafterorthoplasticreconstruction