Comparative Study of Olecranon Osteotomy versus Paratricipital Approach for Intra-Articular Fracture of Distal Humerus in Maharashtra Population: A Retrospective Study
Background: Management of distal humerus fractures continues to be a challenge for orthopedic surgeons. The unique and complex anatomy of the distal humerus, involving ulna-humeral and radiocapitellar joints, makes anatomic reduction difficult and hardware placement challenging.
Materials and Methods: Out of 28 cases, 14 had olecranon osteotomy (OO) and 14 had paratricipital (PT) approach. The surgery was carried out under general anesthesia. Mid-line posterior incision was used with slight lateral bent on olecranon tip to avoid the weight-bearing zone ulnar nerve was identified first, then release of the ligament of struthers and medical intermuscular septum was done to transpose the ulnar nerve. All fractures were fixed as per AO principles using bicolumnar plating. Range of motion was measured by goniometer. Functional assessment was done by Mayo Elbow Performance Score (MEPS).
Results: Parameters of OO and PT were compared, mean values were more or less similar values but MEPS shows variations in C3 type fractures in PT studies, as compared to OO.
Conclusion: The PT approach and the OO approach can be used alternatively for AO-13 C1 and C2 fractures with similar outcomes. However, in type C3, the PT approach yields poor outcome in comparison with OO approach.
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