New possibilities of osteosynthesis of the distal humerus

Fractures of the distal humerus account for about 0.5-2.5% of all fractures of the bones of the skeleton, 15% of all fractures of the humerus, about 30% of fractures of the elbow joint and 7.8-24% of all fractures of the upper limb. At the same time, intraarticular fractures of the distal humerus (DPK) account for 10-24% of all intraarticular fractures. The difficulties in treating patients with fractures of this localization are due to the complex anatomy and biomechanics of this area, the predisposition of the elbow joint to the development of post-traumatic contractures and heterotopic ossifications, as well as the high demands of patients on the results of rehabilitation treatment. Subcutaneous subfascial osteosynthesis is one of the methods of surgical treatment of fractures of the distal humerus, which allows to restore the anatomy of this segment and provides a good functional result. An important advantage of this method is that when using it, traumatization of neurovascular structures is minimized, since access is carried out through anatomical safe zones.Aims: based on our experience in the surgical treatment of patients with fractures of the distal humerus, to show the advantages of subcutaneous subfascial osteosynthesis to improve the quality of treatment results in this category of patients.Materials and methods: we observed 74 patients with fractures of the periarticular distal humerus. Surgical treatment was carried out in the conditions of the Tula Regional Clinical Hospital. The age of the patients ranged from 18 to 73 years. The operations were performed within 1-3 weeks after the injury. The method of subcutaneous subfascial osteosynthesis was used in 10 patients.Results and conclusions: subcutaneous-subfascial osteosynthesis refers to minimally invasive methods of surgical treatment of fractures and corresponds to modern trends in traumatology and orthopedics, as it provides stable fixation of fragments in fractures of the lower third of the shoulder and minimizes traumatization of soft tissues and neurovascular structures