Osteosynthesis of Distal Humeral Metaepiphyseal Fractures Via Posterior Approach with Olecranon Preservation

Abstract


Eighteen patients with distal humeral metaepiphyseal fractures were operated on during the period from 2010 to 2013. Mean age of patients made up 43.1±8.4 (22-72) years, term after injury - 4.6±1.9 (2-11) days. According to AO classification C1 fractures were diagnosed in 13, C2 - in 3, C3 - in 2 patients. In all patients distal humeral metaepiphyseal osteosynthesis with two plates placed at 90° to each other was performed. Surgical intervention was performed without olecranon osteotomy and triceps tendon was kept intact. In 12 (66.7%) cases longitudinal dissection of the triceps in its middle third was performed. Residual intraarticular displacement averaged 0.2±0.03 mm. Long term results were assessed in 10 patients at an average 12 months after operation. Mean score by subjective and objective scales made up 4.3±0.3 and 4.2±0.3 points, respectively. Main advantages of the applied osteosynthesis technique were preservation of forearm extensor muscles integrity; absence of additional fixatives in olecranon zone; absence of the necessity to perform additional intervention to remove fixatives from the olecranon.

About the authors

V. A Kalantyrskaya

Clinical hospital for emergency care named after N.V. Solov’yov, Yaroslavl’

Email: kalan.v@mail.ru

I. O Golubev

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia


References

  1. Patterson S.D., Bain G.I., Mehta J.A. Surgical approaches to the elbow. Clin. Orthop. Relat. Res. 2000; 370: 19-33.
  2. MacAusland W.R. Ankylosis of the elbow, with report of four cases treated by arthroplasty. JAMA. 1915; 64: 312-8.
  3. Dakouré P.W., Ndiaye A., Ndoye J.M., Sané A.D., Niane M.M., Séye S.I., Dia A. Posterior surgical approaches to the elbow: a simple method of comparison of the articular exposure. Surg. Radiol. Anat. 2007; 29 (8): 671-4.
  4. Tak S.R., Dar G.N., Halwai M.A., Kangoo K.A., Mir B.A. Outcome of olecranon osteotomy in the trans-olecranon approach of intraarticular fractures of the distal humerus. Ulus Travma Acil Cerrahi Derg. 2009; 15 (6): 565-70.
  5. McKee M.D., Wilson T.L., Winston L., Schemitsch E.H., Richards R.R. Functional outcome following surgical treatment of intra-articular distal humeral fractures through a posterior approach. J. Bone Joint. Surg. Am. 2000; 82-A (12): 1701-7.
  6. Van Gorder G.W. Surgical approach in supracondylar T fractures of the humerus requiring open reduction. J. Bone Joint Surg. Am. 1940; 22: 278-92.
  7. Alonso-Llames M. Bilaterotricipital approach to the elbow. Acta Orthop. Scand. 1972; 43: 479-90.
  8. Amirfeyz R., Clark D., Quick T., Blewitt N. Newcastle approach to the elbow, a cadaveric study. Arch. Orthop. Trauma Surg. 2011; 131 (6): 747-51.
  9. Миронов С.П., Бурмакова Г.М. Повреждения локтевого сустава при занятии спортом. М.: Лесар-арт; 2000.
  10. Elmadag M., Erdil M., Bilsel K., Acar M.A., Tuncer N., Tuncay I. The olecranon osteotomy provides better outcome than the triceps-lifting approach for the treatment of distal humerus fractures. Eur. J. Orthop. Surg. Traumatol. 2014; 24 (1): 43-50.

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