An Integrated Approach to the Treatment of Intra-Articular Fractures of the Distal Humerus

Introduction. The number of people with severe multicomminuted fractures of the distal humerus is increasing every year. This trend has a negative impact on the outcomes of treatment of such fractures, which confirms the urgency of the problem of providing care to patients with intra-articular fractures of the distal shoulder.

Materials and methods. The results of treatment of 217 patients, 2001–2022: the control group was retrospective data of 137 cases with fractures of the humerus, the main group was 80 patients treated using innovative developments.

Results. Innovative developments in elbow joint surgery, including a new device for bone fragment reposition, an external fixation device for elbow joint, and a transosseous access method, have been introduced into clinical practice. These developments have improved the treatment outcome and reduced the number of complications during transosseous osteosynthesis from 16.67 % to 5.56 %.

Discussion. Factors affecting postoperative elbow joint functionality include fracture complexity, choice of fixation technique, and choice of surgical approach. The method allows to avoid total elbow joint endoprosthetics, providing clinical results without significant limitation of activity and to ensure anatomical restoration of the articular surface and functions. To reduce the risk of complications, an integrated approach has been developed, including optimization of diagnostics, treatment, and rehabilitation.

Conclusion. The use of advanced methods for optimizing surgical treatment of patients with fractures of the distal humerus allows to improve the results of medical rehabilitation, increasing the effectiveness of treatment and reducing the number of complications.

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