Intra-articular distal humerus fracture – TRAP or olecranon osteotomy

Abstract

: Intra-articular distal humeral fractures can be approached in a variety of ways. The purpose of this study is to evaluate and compare the functional outcomes of two approaches: one with olecranon osteotomy and other with triceps-lifting approach; for the treatment of intra-articular distal humeral fractures.: In this study, 10 patients in Group A were compared with 10 patients in Group B. Both the groups were comparable in terms of age, gender, duration of injury and degree of comminution of the fracture. Results were compared in terms of operative time, hospital stay, union, range of motion and complications. Functional evaluation was done using the Mayos’ elbow performance score (MEPS).: Patients were followed for a minimum of 12 months. Fracture union was seen at or before 4 months in all the patients of both the groups, except in 1 case of Group A where it was seen at 7 months. Average time to union was comparable in both the groups. In Group A, mean range of flexion was found to be 118 degrees (SD 7.33) and extension lag was found to be 11 degrees (SD 3.84). In Group B, mean degree of flexion was found to be 118.25 (SD 4.94) and extension loss of 12 degrees (SD 4.70). Average range of motion was comparable in both groups. There were no significant differences noted between the two groups in terms of mean MEPS (p= 0.573). The overall complication rate was 40% in the TRAP group and 30% in the olecranon osteotomy group.: Intra-articular distal humerus fractures mandate surgical fixation for best functional outcomes. Although technically demanding, TRAP exposure can prove to be as effective as olecranon osteotomy approach. Both approaches appear to yield no significant differences in clinical and functional results for intra-articular distal humerus fracture management.