Which Treatment is Best for Adult Humerus Distal 1/3 Fractures Without Extension to the Elbow Joint?

Abstract Adult humeral fractures that do not extend to the elbow joint can be seen with low-energy trauma in the elderly and high-energy trauma in the young. Fractures of the distal 1/3 of the humerus are treated with surgical and non-surgical methods. Our study aimed to evaluate the functional and radiological results of the distal 1/3 humerus fractures, which do not involve the joint, by comparing the conservative and surgical treatments and the surgical techniques used. Materials and Methods Thirty-five patients with adult distal 1/3 humeral fractures that did not extend to the joint between January 2010 and October 2014 were included in the study. The cases were evaluated retrospectively. Results 9 of the cases were female and 26 were male. The mean age of the patients was 33,6. Articular range of motion (ROM) of cases was measured averagely at 118,8˚, and extension loss was measured at 7,14˚ averagely. The average Mayo score of cases had been measured at 87 . Mono plaque osteosynthesis has been applied to 20 of cases (Group I), double plate osteosynthesis has been applied to 11 (Group II), and conservative treatment has been applied to 4 (Group III). A statistical significant difference between Group I and Group II has not been determined regarding union time, complication, Mayo Score, Cassebaum’s rating, ROM, and extension loss. According to surgical approaches applied to patients (lateral-posterior), while a statistical difference has not been determined regarding complications, union time, and ROM, a significant difference has been determined regarding Mayo Score and extension loss. According to different determination methods; a statistical difference has not been determined regarding to complications, ROM, extension loss, Mayo Score and union time. Discussion We recommend surgery with a lateral approach to preserve the extensor mechanism in fractures of the distal 1/3 of the humerus.