Comparative study of functional outcome between olecranon osteotomy and triceps lifting approach in osteosynthesis of distal humerus fracture

Abstract

Introduction: Intra-articular distal humeral fractures are very complex fractures. A variety of approaches are used to treat this fracture. The purpose of this study is to evaluate and compare the functional outcomes of two approaches that are olecranon osteotomy and triceps-lifting approach for the treatment of intra-articular distal humeral fractures. Methods: This study includes 30 intra-articular distal humeral fractures patients who were treated with open reduction and internal fixation with anatomic plating by two different approaches. Lateral plating was performed in 6 patients, and medial and lateral parallel plating was performed in 12 patients in the olecranon osteotomy group, while lateral plating was performed in 3 patients, and medial and lateral parallel plating was performed in 9 patients in a triceps-lifting group. It includes retrospective and prospective study in the department of orthopaedic in DR. D Y Patil Medical College Kolhapur during the period from June 2017 to June 2019. Results: After regular follow and after assessing the patient we came to the result that functional outcomes according to MAYO elbow score and extension-flexion motion arc values were significantly better in the olecranon osteotomy group. The mean complication rate in olecranon osteotomy was 33% and in tricep lifting approach the mean complication rate was 50%. Conclusion:Olecranon osteotomy approach has better functional outcomes than the triceps-lifting approach. Intra-articular distal humerus fractures can be safely treated with olecranon osteotomy which provides more control over the elbow joint and better visualization and allows early postoperative rehabilitation.