International Orthopaedics

, Volume 42, Issue 4, pp 921–926 | Cite as

Evaluation of risk factors for stiffness after distal humerus plating

  • Onur Tunalı
  • Ali Erşen
  • Tuna Pehlivanoğlu
  • Serkan Bayram
  • Ata C. Atalar
  • Mehmet Demirhan
Original Paper



In distal humerus fractures, the goal is to achieve a functional range of motion of 30°–130° which is not always possible. The aims of the study were to evaluate the functional results after distal humerus fracture operation and to investigate the risk factors for stiffness.


Between 2005 and 2014, 75 patients with the mean age of 37.8 years (17–80) underwent open reduction and plate fixation for distal humerus fractures. Range of motion (ROM), Mayo elbow performance scores, and quick DASH scores were used for functional evaluation. Patients were divided into two groups according their ROM. Group 1 had > 100° of extension-flexion ROM and group 2 had < 100°. Older age (> 60), AO type C2–3 fracture, open fracture, longer injury-surgery interval, type of plating, and presence of olecranon osteotomy were investigated as risk factors for poor outcome.


At a mean follow-up of 25 months (6–80), 40 patients were in group 1 and 35 patients were in group 2. Group 1 had significantly better functional scores than group 2. AO type C2 and C3 fracture (odds ratio (OR) 16.6, p < 0.0001) and injury-surgery interval longer than 7 days (OR 2.59, p 0.047) were found as significant risk factors for stiffness.


Patients who had distal humerus fracture should be informed about the risk of elbow stiffness especially in AO type C2–C3 fractures and surgical treatment should be planned without any delay.


Distal humerus fracture Risk factors Double plate fixation Stiffness 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of İstanbul University İstanbul Medical Faculty Orthopaedics and Traumatology Department.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Onur Tunalı
    • 1
  • Ali Erşen
    • 2
  • Tuna Pehlivanoğlu
    • 2
  • Serkan Bayram
    • 2
  • Ata C. Atalar
    • 3
  • Mehmet Demirhan
    • 4
  1. 1.Zekeriyaköy Outpatient Clinic Orthopaedics and Traumatology DepartmentAcıbadem Health Group Maslak HospitalIstanbulTurkey
  2. 2.Istanbul Medical Faculty Orthopaedics and Traumatology DepartmentIstanbul UniversityİstanbulTurkey
  3. 3.Acıbadem University Medical Faculty Maslak Hospital Orthopaedics and Traumatology DepartmentİstanbulTurkey
  4. 4.School of Medicine Orthopaedics and Traumatology DepartmentKoc UniversityİstanbulTurkey

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