| Anatomical reduction of distal humeral fractures requires exposure of articular fragments. These fractures are treated with
olecranon osteotomy, the gold standard. As a result of Von Gorder's approach, the articular surface of the distal humeral
fracture is exposed via an inverted V-shaped flap of distal tricep. In our study, Von Gorder's approach was used to reduce
and fix distal humeral fractures in order to evaluate functional outcome. The total number of patients with AO Type C
distal humeral fractures was 21, of which 10 were C1 type, 6 were C2 type, and the remaining five were C3 type. Von
Gorder approved open reduction and internal fixation for all patients. A total of 21 bicolumnar fractures were repaired with
recon plates and dynamic compression plates, whereas 3 fractures were repaired with precontoured locking plates.
Radiological and clinical follow-up were performed in all cases. In order to determine the functional outcomes of patients,
it was necessary to determine the Mayo Elbow Performance Score (MEPS). Across all patients during the final follow-up
period, 16 (66% of patients) had a good to excellent outcome, 4 (23%) had a fair outcome, and 1 (11%) had a poor
outcome. The mean MEPS score at last follow-up was 87. Despite 86% of patients having decreased terminal range of
flexion/extension, their functional movement range was good in spite of losing their rotatory motion. As of 123.0° flexion
(range 90°-135°) and 7° extension (range 0°-13°), the range of flexion was 123.0°, and the range of extension was 7°.
Most distal humeral fractures can be treated with the triceps reflecting approach because it provides adequate visualization
and reduction, but fractures involving the anterior capitellum and joint commination should not be treated this wayddd |
