Paratricepital approach for fixation of distal humerus fracture in adults - A good alternative

Mondal, Jayati; Krishna, Chaitanya; Ganguli, Ritwik; Sabui, Kanchan Kumar

doi:10.22271/ortho.2017.v3.i2e.50

Cited by 5 publications

(7 citation statements)

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“…Additionally, the paratricipital approach preserves innervation and blood supply of the anconeus muscle, which contributes to dynamic posterolateral stability of the elbow joint. 1) …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, when the field of view is limited and reduction is difficult using the paratricipital approach, it is possible to switch to an olecranon osteotomy approach, although this was not necessary in the current study. 1) …”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment of intra-articular distal humeral fractures is challenging for even the most experienced surgeons. 1) It is technically demanding, and achieving adequate exposure of the articular surface is important. Additionally, distal humeral fractures have a high risk of postoperative dysfunction and complications, such as nonunion and elbow stiffness.…”

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confidence: 99%

“… 13 14) The paratricipital approach suggested by Schildhauer et al 15) has become popular for distal humeral intra-articular fractures because it permits early active range of motion (ROM) of the elbow, maintenance of the blood supply, and innervation of the anconeus muscle, which contributes to dynamic posterolateral stability of the joint. 1) Favorable outcomes have been reported for fixation of type 13C2 fractures using this approach, but limited exposure of the articular surface remains a potential disadvantage of the approach. 9 16)…”

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confidence: 99%

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Are Outcomes Comparable for Repair of AO/OTA Type 13C1 and Type 13C2 Distal Humeral Fractures Using the Paratricipital Approach?

et al. 2022

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Background Studies have reported favorable outcomes using the paratricipital approach for fixation of distal humeral intra-articular fractures. However, literature evaluating the clinical results of the approach remains limited. The objective of this study was to compare clinical outcomes between type 13C2 and type 13C1 distal humeral fractures after open reduction and internal fixation performed using the same approach and same type of plate. Methods A total of 52 adults with type 13C1 or 13C2 distal humeral fractures were treated surgically at our institution during 2006 to 2018. We retrospectively analyzed data from 29 of these patients (19 with type 13C1 fractures and 10 with 13C2 fractures) who met the inclusion criteria. All subjects were followed for a minimum of 2 years postoperatively. Clinical and radiologic results were analyzed to determine differences in outcomes between the two types of fractures. Clinical results were evaluated using elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), and Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score. Alignment, fracture union, and presence of posttraumatic arthritis were evaluated radiologically. Results The patients’ mean age was 51 years, and the mean duration of follow-up was 29 months. Mean ROM was 129.5° ± 21.5° in the type 13C1 group and 123.0° ± 20.6° in the 13C2 group ( p = 0.20). Mean Q-DASH score was 12.6 ± 11.7 in the 13C1 group and 16.2 ± 19.8 in the 13C2 group ( p = 0.60). Mean MEPS was 92.9 ± 8.5 in the 13C1 group and 85.0 ± 14.1 in the 13C2 group ( p = 0.09). Carrying angle did not differ significantly between the 13C1 and 13C2 groups. No patient in either group exhibited nonunion or posttraumatic arthritis. Conclusions Although the paratricipital approach has the disadvantage of limited visualization of articular surfaces, there were no differences in surgical outcomes between type 13C1 and type 13C2 distal humeral fractures after fixation using this approach. Thus, surgeons may need to consider using the paratricipital approach for open reduction and internal fixation of 13C2 distal humeral fractures.

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“…Additionally, the paratricipital approach preserves innervation and blood supply of the anconeus muscle, which contributes to dynamic posterolateral stability of the elbow joint. 1) …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Are Outcomes Comparable for Repair of AO/OTA Type 13C1 and Type 13C2 Distal Humeral Fractures Using the Paratricipital Approach?

et al. 2022

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“…Drawbacks of this method are extended duration of the operation to conduct osteotomy and fixation procedure, and increased likelihood of restricted post-operative mobilization and physiotherapy [1,2,6]. Moreover, frequent complications are reported to be symptomatic malfunction of olecranon fixation devices which may have to be removed surgically, non-united olecranon, and elimination of osteotomy reduction.…”

Section: Introductionmentioning

confidence: 99%

Outcomes Following Alonso-Llames Triceps-Sparing Approach for Type-C Distal Humerus Fractures: A Single Center Study

Widodo¹,

Wira²,

Luthfi³

2019

JCR

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Introduction: The elbow joint is a combination of stability and motion of three individual articulations. Disruption resulting from distal humerus fractures will affect the functions and motions of the elbow joints significantly. Adequate restoration of elbow function compels reconstruction of the anatomical articular surface and steady fixation of the fractured fragments for early and complete rehabilitation. Any disruption of the triceps from the olecranon leads to weakened extension power. Triceps-sparing techniques may be able to maintain elbow strength by keeping the olecranon-triceps unit intact. Methods: A retrospective study was completed in Cipto Mangunkusumo Hospital, Jakarta comprising five cases of inter-condylar fracture of the humerus. The fractures types were AO type C1 and C2 fractures of the distal humerus. Exposure of supra-condylar ridges on the distal humerus were achieved by raising the medial and lateral flaps as in Alonso-Llames triceps-sparing approach. Double plating was used in all cases to stabilize the fractures fragment. Results: All five fractures had achieved union at the fourth month of followup. None of the patients endured loss of supination or pronation though all patients had several degree of flexion/extension reductions compared with the normal side. The mean Mayo Elbow Performance Index (MEPI) was 94 (range 85 to 100) representing superb outcome in twelve months follow up. Conclusion: The usage of triceps-sparing method to uncover type C distal humerus fractures led to decreased post-operative complication rate and quicker patient recovery without reducing the view of the articular surface or disturbing fracture reduction during fixation.

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Inclusion of Olecranon Osteotomy With the Posterior Approach for Fixation of Distal Humerus Fractures (OTA/AO 13) Does Not Increase Surgical Complications

Wilson

Buckwalter

Henning

et al. 2021

Journal of Orthopaedic Trauma

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Paratricepital approach for fixation of distal humerus fracture in adults - A good alternative

Cited by 5 publications

References 0 publications

Are Outcomes Comparable for Repair of AO/OTA Type 13C1 and Type 13C2 Distal Humeral Fractures Using the Paratricipital Approach?

Are Outcomes Comparable for Repair of AO/OTA Type 13C1 and Type 13C2 Distal Humeral Fractures Using the Paratricipital Approach?

Outcomes Following Alonso-Llames Triceps-Sparing Approach for Type-C Distal Humerus Fractures: A Single Center Study

Inclusion of Olecranon Osteotomy With the Posterior Approach for Fixation of Distal Humerus Fractures (OTA/AO 13) Does Not Increase Surgical Complications

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