Outcome of Open Reduction & Internal Fixation of T-Y Intercondylar Fracture (AO type C) of Distal Humerus in Adults by Bicolumnar Locking Plates

Open Access

Abstract

Background: Distal humerus fractures account for 2% of adult fractures and are surgically challenging due to complex elbow anatomy and articular comminution. AO type C intercondylar fractures are especially demanding; conventional implants often fail in small distal fragments. Bicolumnar locking plates in a 90°-90° configuration offer angular-stable fixation and early mobilization. Objective: To evaluate radiological and functional outcomes of AO type C distal humerus fractures in adults treated by open reduction and internal fixation with bicolumnar locking plates. Methods: A prospective observational study at the Department of Orthopaedic Surgery, Dhaka Medical College Hospital, ran over 18 months with a six-month follow-up. Twenty-two adults with closed AO type C fractures were enrolled. All underwent open reduction & internal fixation (ORIF) via a triceps tongue approach. Radiological union was graded by the Hammer criteria; functional outcome by the Mayo Elbow Performance Score (MEPS). Analysis used SPSS version 26 (p < 0.05). Results: Mean age was 41.7 years with equal gender distribution. Road traffic accidents were dominant (68.2%) and AO 13C2 was the most frequent fracture type (68.2%). The mean injury-to-surgery interval was 11.9 days. Union was achieved at 19.9 weeks; 59.1% attained Grade 1 union. Mean MEPS was 81.82. Good and excellent outcomes were recorded in 45.5% and 31.8% respectively, giving a satisfactory rate of 95.5%. Age and comorbidities were significant outcome predictors. Conclusion: ORIF with bicolumnar locking plates yields reliable union and favourable functional recovery in AO type C distal humerus fractures with minimum complications.