Clinical analysis of the olecranon osteotomy and brachial triceps brachii approach in the treatment of adults with type C distal humeral fracture

JIANG Ben-tao; JIANG Jun-wei; ZHANG Xue-liang

doi:10.3969/j.issn.1009-4237.2017.04.013

Abstract：Objective To explore the effects of the olecranon osteotomy and brachial triceps brachii approach in the treatment of adult patients with type C distal humeral fracture.Methods Sixty adults with type C distal humeral fracture hospitalized in our hospital from Jan.2010 to Dec.2014 were included in our study,including 39 males and 21 females with an average age of 41.6(18-62) years.42 cases were treated with the posterior olecranon osteotomy approach (12 cases with type C1,11 cases with type C2,19 cases with type C3) and 18 cases were treated with brachial triceps brachii approach (15 cases with type C1,3 cases with type C2).Results All 60 cases were followed up for 6 to 18 months,with an average of 13.4 months.All the fractures were healed in the following 13 to 25 weeks,with an average of 16.5 weeks.There was neither loosening nor fracture of internal fixation,nor infection of wound,nor necrosis of skin.Postoperative recovery was evaluated as excellent in 12 cases,good in 20 cases,fair in 6 cases and poor in 4 cases,with an excellent and good rate of 76.2％ totally.Joint function evaluation of the patients treated with brachial triceps brachii approach was considered as excellent in 8 cases,good in 7 cases and fair in 3 cases,with an excellent and good rate of 83.3％.Conclusion Selection of operation method for adults with type C distal humeral fracture via olecranon osteotomy approach or brachial triceps brachii approach properly,reducing muscular injury,achieving articular surface anatomical recovery,combined with fixation with double plate and early exercise after operation,can achieve a significant clinical effect.