Comparative analysis of surgical plasty of bone defects in distal humerus fractures

Objective: to conduct a comparative analysis of the plastic surgery outcomes of bone defects in various locations in distal humerus fractures using block and cancellous allografts. Materials and methods. The study included 56 patients with comminuted fractures of the distal humerus distributed among 3 groups depending on the bone defect location and 2 subgroups based on the bone grafting. Elbow joint function was assessed using the Broberg and Morrey rating system, pain syndrome was evaluated according to the visual analog scale. Results. The amplitude of flexion and extension movements of the elbow joint in medial area defects 1.5 months after plastic surgery with a block allograft reached 90±5º (p=0.04) and 75±6º when using cancellous allograft. Three months after surgical repair with a block allograft, the strength and pain scores for defects reached 80±2 pts in the central area, 82±3 pts in the lateral area and 88±4 pts in the medial column. For cancellous allograft, these scores were 59±5 pts (p=0.01), 62±3 pts (p=0.01) and 60±3 pts (p=0.03), respectively. Conclusion. The plasty of the bone defect with a block allograft for distal humerus fractures contributes to an increase in the multiplanar range of motion 1.5 months after surgery for a medial column defect, and also improves strength and increases range of the flexion and extension motion, and reduces pain 3 months after surgery for defects of the medial, lateral and central metaphyseal locations.