Therapeutic effect of ulnar nerve with or without transposition during open reduction and internal fixation of distal humerus fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of ulnar nerve with or without transposition during open reduction and internal fixation of distal humerus fractures.Methods A retrospective case control study was made on 74 cases receiving open reduction and internal fixation of distal humerus fractures between January 2008 and December 2015.There were 28 males and 46 females,with a mean age of 63.2 years (range,32-83 years).AO fracture classification was A2 type in seven cases,A3 type in four,C1 type in 14,C2 type in 28 and C3 type in 21.According to the intraoperative management of the ulnar nerve,the patients were divided into transposition group (n =43) and non-transposition group (n =31).Two groups were compared with respect to operation time,Mayo elbow performance score (MEPS),incidence of ulnar neuritis and postoperative complications.Results Follow-up lasted for 6-24 months (mean,11.7 months).Operation time differed significantly between transposition group [(110.9 ± 20.8) minutes] and non-transposition group [(95.6 ± 18.9) minutes] (P ＜ 0.05).MEPS in transposition group was excellent in 15 cases,good in 20,fair in six and poor in two.MEPS in non-transposition group was excellent in 10 cases,good in 15,fair in five and poor in one,with the same excellence rate of 81％ in comparison with transposition group (P ＞ 0.05).Incidence of ulnar neuritis showed no significant difference between transposition group (9％,4/43) and non-transposition group (7％,2/31) (P ＞0.05).Postoperatively,one case of superficial wound infection and two delayed healing were noted in transposition group;one case of superficial wound infection and one delayed healing were noted in non-transposition group.There was no significant difference in incidence of postoperative complications between groups (P ＞0.05).Conclusions Ulnar nerve with or without transposition can both achieve satisfactory clinical effect during open reduction and internal fixation of distal humerus fractures.But non-transposition group is associated with shorter operation time without increasing the incidence of ulnar neuritis.