L’ostéotomie de l’olécrâne dans le traitement des fractures de la palette humérale de l’adulte : évaluation anatomique et fonctionnelle du coude à propos de 14 cas

Sané, A.; Dakouré, Patrick Wendpouiré Hamed; Diémé, C; Kinkpé, C.V.A.; Dansokho, A V; Ndiaye, A.; Seye, S.

doi:10.1016/j.main.2008.12.004

Cited by 20 publications

(12 citation statements)

References 19 publications

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“…Olecranon osteotomy through a posterior approach has been the gold standard for intraarticular fractures of distal humerus 1819. However, reconstruction of osteotomy may lead to delayed union, nonunion, and prominence of implant, which may require additional surgery 234567. Similarly, a triceps-splitting approach does not expose the articular surface adequately compared with other approaches as shown by Wilkinson and Stanley in their cadaveric study; this approach has a further disadvantage of direct muscle trauma leading to fibrosis and damage to intermuscular nerve branches, which can cause muscle weakness 2021.…”

Section: Discussionmentioning

confidence: 99%

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Functional outcome of intraarticular distal humerus fracture fixation using triceps-sparing paratricipital approach

Yadav

Sharma

Gohiya

2016

IJOO

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Background:Displaced intraarticular distal humerus fracture has been conventionally treated operatively with various triceps disrupting approaches. These approaches are associated with several complications, such as triceps weakness, nonunion or delayed union of osteotomy, implant prominence, and delayed mobilization of the elbow. We present the functional outcome of intraarticular distal humerus fracture fixation using a triceps-sparing paratricipital approach which allows early elbow mobilization and preserving triceps strength.Materials and Methods:Twenty five patients with intraarticular distal humerus fracture were operated using triceps-sparing paratricipital approach with orthogonal plate construct. There were 16 male and 9 female patients and average age was 42.16 years (range 23-65 years). The mechanism of injury was fall from height (n = 8), road traffic accident (n = 13) and ground level fall (n = 4). Clinical, radiological, and functional assessment with Mayo Elbow Performance Index (MEPI) were obtained at follow up period.Results:All fractures united primarily. At the mean follow up of 13.58 months (range 6-22 months), mean elbow flexion was 121.08° (range 94°–142°) and mean motion arc was 114.92°(range 65°-140°). The mean MEPI score was 94.40 points (range 70–100) with 17 excellent, five good, and three fair results. The mean flexion deformity or extension loss was 6.16° (range 5°–15°).Conclusion:Open reduction and internal fixation of intraarticular distal humerus fractures with triceps-sparing paratricipital approach provide adequate exposure with no adverse effect on triceps muscle strength and allows early initiation of elbow motion. We analyzed, age and injury to surgical interval with relation to functional range of elbow using Z-test which is insignificant.

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Section: Discussionmentioning

confidence: 99%

“…These approaches are often associated with complications, such as delayed union or nonunion at the osteotomy site, prominence of the implant, triceps weakness, wound dehiscence, triceps avulsion, delayed mobilization, and failure to gain early elbow function 234567…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of intraarticular distal humerus fracture fixation using triceps-sparing paratricipital approach

Yadav

Sharma

Gohiya

2016

IJOO

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“…Sané et al [ 22 ] reported on the clinical results of fourteen elbows in which a transverse osteotomy of the olecranon was re-fixated with Kirschner wires and tension band.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of the re-fixation of a Chevron olecranon osteotomy using an intramedullary cancellous screw and suture tension band

Wagener¹,

Dezillie²,

Hoendervangers³

et al. 2015

Strategies in Trauma and Limb Reconstruction

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Exposure of the distal humerus in case of an articular fracture is often performed through a Chevron osteotomy of the olecranon. Several options have been described for re-fixation of the Chevron osteotomy. Pull-out of the hard-wear is often seen as complication. In this study, an evaluation of the re-fixation of the Chevron osteotomy through a cancellous screw and suture tension band was performed. The data of 19 patients in whom a Chevron osteotomy was re-fixated with a cancellous screw in combination with a suture tension band were used. Evaluation was performed by assessment of the post-operative X-rays and documentation of complications. In all 19 cases, evaluation of the post-operative X-rays showed complete consolidation without dislocation or other complications. Re-fixation of a Chevron osteotomy of the olecranon with a large cancellous screw with a suture tension band provides adequate stability to result in proper healing of the osteotomy in primary cases when early post-operative mobilisation is allowed. Complications as pull-out of the hard-wear were not reported.

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“…The treatment of intraarticular distal humerus fractures is subject of continuous debate in the orthopaedic literature [1–13]. They are uncommon, the anatomy is complex, and bone is frequently comminuted [14, 15].…”

Section: Introductionmentioning

confidence: 99%

Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach

et al. 2013

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Several alternative approaches have been described to avoid the complications related to the olecranon osteotomy used to treat distal articular humerus fractures. The published experience with the triceps-sparing approach is scant. In this prospective study, a total of 12 patients with an articular humeral fracture were treated using this approach. At a mean followup of 1,7 years, the average range of motion was 112.8° (range from 85° to 135°); the elbow flexion averaged 125.5° (range from 112° to 135°) and the deficit of elbow extension 14.6° (range from 0° to 30°). All the elbows were stable. The Mayo Elbow Performance Score (MEPS) averaged 93.3 (range from 80 to 100). In the present series no failure of the triceps reattachment to the olecranon was found, and all the patients recalled returning to their previous daily life activities without impairment with a satisfactory MEPS. As a conclusion, the triceps-sparing approach can be considered for treating distal articular humerus fractures. We consider that three clinical settings can be more favorable to use this approach: those cases in which a total elbow prosthesis might be needed, cases of ipsilateral diaphyseal fracture, or presence of previous hardware in the olecranon.

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L’ostéotomie de l’olécrâne dans le traitement des fractures de la palette humérale de l’adulte : évaluation anatomique et fonctionnelle du coude à propos de 14 cas

Cited by 20 publications

References 19 publications

Functional outcome of intraarticular distal humerus fracture fixation using triceps-sparing paratricipital approach

Functional outcome of intraarticular distal humerus fracture fixation using triceps-sparing paratricipital approach

Clinical results of the re-fixation of a Chevron olecranon osteotomy using an intramedullary cancellous screw and suture tension band

Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach

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