EFFECTS OF DELAYED SURGICAL INTERVENTION, DELAYED PHYSIOTHERAPY AND IMPLANT CHOICE ON FUNCTIONAL OUTCOME OF BI-COLUMNAR FIXATION TECHNIQUE FOR DISTAL HUMERUS FRACTURES IN AABET HOSPITAL ADDIS ABEBA ETHIOPHIA

Abstract

Summary Background: Distal Humerus fractures are complex injuries with limited options for internal fixation due to their multi-fragmented nature and osteopenic bone. Bicolumnar plating is a stable form of internal fixation that allows for the early mobilization of the joint. Despite global research on distal Humerus fractures, there is a lack of studies on functional outcomes in our country. Thus, this study can serve as a valuable guide for further research and development of guidelines. Objective: To assess effects of delayed surgery, delayed physiotherapy and implant choice on functional outcome in patients with distal humerus fractures treated with bi-columnar fixation. Methods: A health facility-based cross-sectional study design conducted among patients with distal humerus fractures treated with bi-columnar fixation at AABET hospital. Data were collected by reviewing existing medical records and objectively evaluating the patients. The study was conducted on a sample size of 52 and Purposive sampling technique was used. Descriptive statistics such as frequency and percentage were used to summarize the results. Multivariable ordinal logistic regression and one-way ANOVA, were used for the analysis. P value < 0.05 was considered statistically significant. Results: This study constituted 39(75%) males and 13(25%) females. The magnitude of excellent and good clinical outcomes was 61.5% and the mean elbow functional outcome was 75.8±9.8. Delay in surgery1.74(1.31,2.313), had significant effects on the functional outcome (p<0.05). Delay in early physiotherapy, and use of non-rigid plates like one-third tubular plates had significant difference on the functional outcome (p<0.05). Conclusion: The mean MEP score of this study 75.8±9.8 is worse than most other studies. Delay in surgery, was associated with worse clinical outcomes. use of non-locking plates, and delay in physiotherapy had a significant difference on functional outcome compared to use of locking plates and early physiotherapy in the bi-columnar fixation of distal humerus fractures respectively. Key Words; Distal humerus fracture, bi-columnar fixation