Modern practice of surgical treatment of distal humerus fractures: results of a systematic review and new prospects

Introduction: distal humerus fractures (DHU) are a significant problem in traumatology and orthopedics due to the technical complexity of treatment and high frequency of complications. The main method of treating this pathology is surgical, which includes open reduction and internal fixation (ORIF), intramedullary fixation, osteosynthesis with external fixation devices and total elbow arthroplasty (TEP). The propose: to assess the current state of the issue of surgical treatment of distal humerus fractures, to analyze the results of current studies devoted to this issue. Materials and methods: the search was conducted in open electronic scientific databases PubMed and databases of the Russian scientific electronic library e-Library using keywords and phrases: surgical treatment, humerus, osteosynthesis, endoprosthetics. Results: the presented review pays special attention to the description and discussion of both classical and innovative approaches in the surgical treatment of the distal humerus, such as the use of pre-contoured plates with variable angle screw fixation (VALP), which have shown advantages in increasing the stability of fixation and improving functional results, especially in patients with osteoporosis. The prospects for the use of 3D printing to create individual implants, bioresorbable materials, nanotechnology and cellular technologies aimed at accelerating bone regeneration and reducing the risk of complications are considered. Conclusion: total elbow arthroplasty is an effective alternative for elderly patients with complex fractures. Innovative technologies such as 3D printing of individual implants, bioresorbable materials and cell technologies open up new perspectives in the treatment of patients with POD, but require further clinical trials and cost-effectiveness assessment.