Letter to editor regarding “Surgical approaches for open reduction and internal fixation of intra-articular distal humerus fractures in adults: A systematic review and meta-analysis”

Injury ◽  
2018 ◽  
Vol 49 (11) ◽  
pp. 2093
Author(s):  
Vipul Vijay ◽  
Raju Vaishya ◽  
Abhishek Vaish
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Distal Humerus ◽  
Surgical Approaches ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Comparative Analysis of Results of Paratricipital Approach and Olecranon Osteotomy in Non Comminuted Distal Humerus Fractures - A Retrospective Study Conducted at a Tertiary Hospital in Kolkata

2021 ◽  
Vol 8 (37) ◽  
pp. 3316-3322
Author(s):  
Subhadeep Ghosh ◽  
Sunit Hazra
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Age Groups ◽  
Distal Humerus ◽  
Extensor Mechanism ◽  
Surgical Approaches ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

BACKGROUND Intercondylar humerus fractures and low transcondylar type fractures of distal humeral often require surgical exposure and anatomical reduction of the articular surface as well as stabilization of the medial and lateral columns of the distal humerus. Traditionally, these injuries have been treated surgically with various extensor mechanism-disrupting surgical approaches. These approaches have often led to delayed union or non-union of the olecranon, triceps weakness, and osteotomy-related prominent implants. To avoid these problems, various extensor mechanism-sparing approaches that provide bicolumnar exposure of the distal part of the humerus have been described, including triceps-splitting and reflecting techniques. The paratricipital approach was developed to avoid the problems of olecranon osteotomy approach for non comminuted distal humerus fractures. The purpose of this study was to compare the paratricipital approach with olecranon osteotomy and evaluate their effects on the functional outcomes of intercondylar fractures of the distal humerus managed with open reduction and internal fixation (ORIF) by reviewing 38 cases of intercondylar distal humerus fractures surgically managed with either of the approaches during 2015 - 2017. METHODS The retrospective study was conducted at our institution, R.G. Kar Medical College, Kolkata from May 2015 to May 2017. OA type C1 and C2 fractures were included in the study. Type C3 fractures were excluded from the study. Distal humeral open reduction and internal fixation (ORIF) was performed with either orthogonal or parallel plate constructs in 38 patients, where paratricipital approach was used in 21 patients and olecranon osteotomy was done for 17 patients. RESULTS Patients in the paratricipital approach group seems to have better range of motion in terms of flexion and extension. Moreover, mayo elbow performance score (MEPS) of the paratricipital group is better than that of olecranon osteotomy group, even more so in younger age groups. CONCLUSIONS We found that ORIF via the paratricipital approach would confer better functional outcomes for simple intra-articular distal humerus fractures in patients of all age groups. KEYWORDS Distal Humerus Fracture, Paratricipital, Olecranon Osteotomy

Open Reduction and Internal Fixation of Distal Humerus Fractures

2006 ◽  
Vol 7 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Matthew L. Ramsey ◽  
Andrea K. Bratic ◽  
Charles L. Getz ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

scholarly journals The role of ulnar nerve subcutaneous anterior transposition during open reduction and internal fixation of distal humerus fractures: a retrospective cohort study

2020 ◽  
Vol 44 (12) ◽  
pp. 2701-2708 ◽  
Author(s):  
Abdulaziz F. Ahmed ◽  
Ashik Mohsin Parambathkandi ◽  
Wai Jing Geraldine Kong ◽  
Motasem Salameh ◽  
Aiman Mudawi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Internal Fixation ◽  
Ulnar Nerve ◽  
Retrospective Cohort Study ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Distal Humerus ◽  
Anterior Transposition ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Abstract Purpose To compare the rates of ulnar nerve neuropathy following ulnar nerve subcutaneous anterior transposition versus no transposition during open reduction and internal fixation (ORIF) of distal humerus fractures. Methods This was a retrospective cohort study at an academic level I trauma centre. A total of 97 consecutive patients with distal humerus fractures underwent ORIF between 2011 and 2018. All included patients were treated with plates (isolated lateral plates excluded) and had no pre-operative ulnar neuropathy. Subcutaneous ulnar nerve anterior transposition was compared versus no transposition at the time of ORIF. The main outcome measure was the rate of ulnar nerve neuropathy. The secondary outcomes were the severity of the ulnar nerve neuropathy and the rate of ulnar nerve recovery. Results Twenty-eight patients underwent subcutaneous ulnar nerve anterior transposition during ORIF, whereas 69 patients had no transposition. Transposition was associated with significantly higher rates of ulnar nerve neuropathy (10/28 versus 10/69; P = 0.027). An adjusted logistic regression model demonstrated an odds ratio of 4.8 (1.3, 17.5; 95% CI) when transposition was performed. Ulnar nerve neuropathy was classified as McGowan grades 1 and 2 in all neuropathy cases in both groups (P = 0.66). Three out of ten cases recovered in the transposition group, and five out of ten cases recovered in the no transposition group over a mean follow-up of 11.2 months (P = 1.00). Conclusion We do not recommend performing routine subcutaneous ulnar nerve anterior transposition during ORIF of distal humerus fracture as it was associated with a significant 5-fold increase in ulnar nerve neuropathy.

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