The comparison of triceps-reflecting anconeus pedicle and olecranon osteotomy approaches in the treatment of intercondylar fractures of the humerus

XIONG Fu-jun; YANG Hong-tao; HE Xi-jing; FENG Hong-wei

doi:10.3969/j.issn.1009-4237.2017.11.007

Abstract：Objective To evaluate the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle ( TRAP ) approach and olecranon osteotomy approach . Methods A total of 180 patients with intra-articular distal humerus fractures in our hospital from Mar .2006 to Jun. 2012 were recruited to carry out a retrospective study .TRAP approach was used in 99 patients (54 males,45 fe-males;age from 22-61 years,mean age 36.6 years),and olecranon osteotomy in 81 patients (49 males,32 females;age from 26-57 years,mean age 35.4 years).Fractures were classified using the AO/ASIF classification.Function-al results were evaluated with the Mayo elbow performance score ( MEPS) and the Disabilities of Arm ,Shoulder and Hand ( DASH) questionnaire score .The postoperative complications of patients in different groups were compared . Results The mean duration of follow-up was 33.6 months (ranged from 14 to 74 months).There was no signifi-cant difference in age,gender or other basic data between two groups (P>0.05).The overall arc of elbow motion at the last follow-up was (108.2 ±21.9)°in the TRAP group,whereas (98.7 ±22.7) °in the olecranon osteotomy group.A significant difference was observed between the two groups in terms of overall mean arc of elbow motion (P<0.05).There was no significant difference between the two groups in mean MEPS and DASH scores at 1,6,12 month after treatment ( P>0.05) .The overall complication rate in the TRAP group was 27.3%,which was signifi-cantly lower than that in the olecranon osteotomy group (54.3%,P<0.05).Conclusion TRAP is an effective approach in the treatment of intra-articular distal humerus fractures that provides better arc of elbow and lower com -plication and reoperation rates .