Fratture del terzo distale di omero. Trattamento con fissatore esterno

Background. There is no agreement in the literature regarding the treatment of fractures of the distal part of the humerus. Although techniques have been used, the authors describe a combined osteosynthesis of such fractures using axial external fixators and cannulated screws. Methods. Twenty-one patients have been treated with external fixation due to an injury involving the upper limb. Six of them had involvement of the distal epiphysis and they were treated with cannulated screws and external fixation. Of the sixteen patients males and five females, none had a bilateral humeral fracture. Four patients however were classified as polytrauma because other organs were involved in the injury. The eighty-five per cent of fractured humeri involved the dominant limb. Results. All fractures healed without any delayed unions. Authors evaluated the axial deviation of the healed bone using roentgenograms, the function of shoulder and elbow joints were evaluated clinically. In nineteen cases the results were assessed as satisfactory. Two patients had a significant limitation of the range of motion of the elbow. Conclusions. The authors accept that the fracture series is short, however previous results show the possibility of providing an early motion of the upper limb; furthermore, the patients were usually able to recover shortly after surgery. For this reasons it is the authors believe that external fixation plays and will play a main role in the treatment of distal fractures of the humerus.