Abstract
The primary aim of this study was to identify risk factors for developing neuritis and its impact on outcome following open reduction internal fixation (ORIF) of distal humerus fractures.
Patients were identified from a prospective trauma database (1995–2010). All fractures of the distal humerus (OA-OTA Type A, B, C) managed with ORIF were included. Prospective long-term follow up was collected by telephone. Demographic data, fracture classification, intraoperative details (time to surgery, tourniquet, approach, fixation technique, nerve transposition), subsequent surgeries, presence of postoperative nerve palsy, complications and range of motion were collected. The Broberg and Morrey Elbow Score and DASH score were used as functional outcome measures.
Eighty-two patients, mean age 50(range, 13–93) were included. 16% (13/82) developed post-operative ulnar neuritis, 7% (6/82) radial neuritis and 5% (4/82) longterm nonspecific dysaesthesia. Short-term (mean 10 months, range 1–120, collected in 82 patients) and long-term (mean 6 years, range 4–18, collected in 45%, 34/75, of living patients) was completed. In patients with nerve complication: average Broberg and Morrey score was 86 (76% good/excellent), average DASH was 24.7(range, 3.3–100) and Oxford Elbow Score was 39.5(range, 18–48). Compared to: 94 (96% good/excellent), 17.7(range, 0–73.3) and 43.8(range, 17–48) in patients without. Mean pain score was 3.7 in patients with nerve complication compared to 2 without. Nerve complications were seen with increased frequency in young, male patients with high energy and Type C injuries.
Nerve complication following ORIF of distal humerus fractures is relatively common. They have detrimental impact on functional outcome. Certain groups appear to be at increased risk.
