Evaluation of the Functional Outcome in Intra-Articular Distal Humerus Fractures Treated by Dual Plating

Background: The complex anatomy of the elbow joint, multiple displaced fragments, and intra-articular extension of the fracture make these cases challenging to treat and prone to complications. Several methods of limited internal fixation, such as Kirschner wires (K-wires), screw fixation, and single plates, have been described. However, these methods do not provide sufficient stability for early mobilization and often yield unpredictable results. The latest generation of pre-contoured anatomical compression locking distal humerus plate systems offers angular stability and rigid fixation for intra-articular distal humerus fractures. This study aims to evaluate the clinical outcomes of distal humerus fractures using dual plate fixation. Methods: After ethics committee approval, this prospective observational study was conducted over a period of 26 months on 20 patients with intra-articular distal humerus fractures. Functional outcome was measured by using the Mayo Elbow Performance Score (MEPS) system. Radiological union was checked at regular intervals. Results: Olecranon osteotomy (65%) showed better outcomes than the paratricipital approach (35%), with 60% of patients achieving excellent MEPS scores at 24 weeks. Radiographic union was observed in 60% of patients by 12-14 weeks, 25% by 16-18 weeks, and 15% by 18-20 weeks [mean ± standard deviation (SD) = 15.00 ± 2.83 weeks]. Mean range of motion (ROM) improved significantly from 65.83 ± 14.89 degrees at 6 weeks to 102.50 ± 15.88 degrees at 24 weeks (P < 0.01). Complications included one case each of wound infection, hardware protrusion, and stiffness, managed with antibiotics or physiotherapy. Conclusion: The dual locking plating for intra-articular humerus fracture may be a better option in terms of stable and rigid fixation, functional outcome, and fewer complications.