Issue 24-2, 2025

Features of Postoperative Management of Patients after Osteosynthesis of Intra- and Periarticular Fractures of the Distal Section of the Humerus: a Prospective Study

Dmitry V. Kvasov¹, Eduard I. Solod^2,*, Kazbek K. Bekshokov²

¹ Tula Regional Clinical Hospital, Tula, Russia
² Peoples' Friendship University of Russia named after Patrice Lumumba, Moscow, Russia

ABSTRACT

INTRODUCTION.  Distal humerus fractures (DHF) often cause blocking of movements in the elbow joint (EJ) and can also lead to disability. This is due to the fact that active movements in the elbow joint after such injuries are almost completely excluded. These injuries can also lead to serious consequences in adult patients, such as delayed tissue regeneration, contractures and consolidation of bone fragments in a functionally disadvantageous position. In case of forced long-term immobilization due to fractures in the lower third of the humerus, the patient and medical staff must make significant efforts to eliminate persistent contractures and restore the former mobility in the elbow joint. In addition, the risk of developing arthrosis in the future in these patients also increases if rehabilitation measures are not carried out in full. All this means that the prevention of post-traumatic contractures and arthrosis in the elbow joint after damage to its bone and/or soft tissue structures remains a topical issue for scientific research.

AIM.  To analyze the methods of rehabilitation of patients after DPC fractures used in the clinic and to establish a correlation between the nature of the fracture and the methods of further rehabilitation measures.

MATERIALS AND METHODS.  In this paper, we analyzed the results of rehabilitation procedures for 142 patients aged 18 to 73 years with different types of DHF who were treated in the trauma department of the Tula Regional Clinical Hospital from 2021 to 2024. To assess the effectiveness of treatment, a scoring system was used according to the DASH and MEPS questionnaires.

RESULTS AND DISCUSSION.  The results after surgical treatment of fractures of the upper limb improve with the use of therapeutic gymnastics and elements of physiotherapy. When analyzing the treatment results, it was found that with the correct use of modern rehabilitation methods, the upper limb function according to the integral DASH and MEPS scales in the medium-term observation period (up to 6 months after surgery) is 4 scores in 64 respondents (45 %), 2–3 scores in 78 cases (55 %). In the long-term period (more than 1 year), this value was 2–3 scores in 32 (22.535 %) and 4 scores in 103 patients (72.535 %), and in 7 patients (4.93 %) we managed to achieve the return of the full range of active and passive movements.

CONCLUSION.  After surgery and subsequent rehabilitation of patients with DPC fractures, restoration of upper limb functions is observed using modern techniques.

KEYWORDS: fractures of the humerus, osteosynthesis, rehabilitation, intra-articular fractures

FOR CITATION:

Kvasov D.V., Solod E.I., Bekshokov К.K. Features of Postoperative Management of Patients after Osteosynthesis of Intra- and Periarticular Fractures of the Distal Section of the Humerus: a Prospective Study. Bulletin of Rehabilitation Medicine. 2025; 24(2):150–158. https://doi.org/10.38025/2078-1962-2025-24-2-150-158 (In Russ.). 

FOR CORRESPONDENCE:

Eduard I. Solod, Е-mail: doctorsolod@mail.ru

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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.