Outcome of Complex Coronal Shear Fractures of the Distal Humerus (Dubberley Type 3) Managed by the Transolecranon Approach.

ABSTRACT

Introduction: Complex distal humerus coronal shear fractures are rare injuries. These fractures involve small articular fragments and are challenging to fix. Design: Aprospective case series of 10 patients was done at a level 1 trauma centre between February 2017 and July 2021. Dubberley type 3 fractures were included in the study. Intervention All patients underwent ORIF using posterior approach with olecranon osteotomy by a single surgeon. Patients were followed up for a minimum of 12 months postoperatively. Outcome Measures: The primary outcome measures were radiographic union and functional status of the limb (DASH score and MEPI score). Results: All patients achieved radiographic union of fracture as well as the osteotomy. The mean DASH score as measured on the final follow-up was 12.6 ± 10.2 and the mean MEPI score was 90 ± 8.2. None of the cases needed reoperation. Conclusion: Consistently good functional outcomes can be obtained in complex coronal shear fractures by posterior approach with olecranon osteotomy. Dubberley type 3b patients should undergo additional plate fixation.