Functional Outcome of Intra-Articular Distal Humerus Fracture Fixation by Orthogonal Plating – In Indian Population: A Case Series

Introduction: The study aimed to evaluate the functional outcomes by treating intra-articular distal humerus fractures using orthogonal plating, with or without olecranon osteotomy. The evaluation criteria included Mayo Elbow Performance score (MEPS), range of motion, and complications arising from surgical management. Materials and Methods: This is a retrospective study of 34 intra-articular distal humerus fractures (AO classification type C) admitted at our institution for 2 years, 6 months from May 2021 to September 2023, all treated with orthogonal plating. Follow-up was for 1 year period at an interval of 3 months. Results: The mean age of the study group was 42.2 ± 14.83 years, ranging from 22 to 76. The mean MEPS was 82.06 ± 10.66. According to MEPS, the outcome was excellent to good in 29 (85.3%) cases, fair in 3 (8.8%), and poor in 2 (5.9%) individuals. Complications such as superficial infection, soft-tissue infection, transient ulnar nerve neuropathy, and elbow stiffness were observed in six out of 34 patients (17.65%), and the mean flexion range was 117.2. Conclusion: This study demonstrates that orthogonal plating for intra-articular distal humerus fractures provides satisfactory functional outcomes. The surgical approach was effective in restoring elbow function with acceptable complication rates. The decision to perform olecranon osteotomy was based on intraoperative visualization needs, and outcomes were comparable between patients with and without osteotomy. No significant differences were observed in functional recovery between right- and left-sided fractures or between male and female patients. Therefore, we conclude that orthogonal plating represents a reliable treatment option regardless of age, gender, or the specific type of intra-articular distal humerus fracture. Keywords: Orthogonal plate fixation, olecranon osteotomy, mayo elbow performance score, intra-articular fracture, distal humerus fractures.