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

BACKGROUND

This study aimed to evaluate the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy.

METHODS

Forty patients with intra-articular distal humerus fractures were retrospectively analyzed. TRAP approach was used in 22 patients (12 males, 10 females; mean age 37.8 years, range 17-70), and olecranon osteotomy in 18 patients (11 males, 7 females; mean age 35.4 years, range 18-62). Fractures were classified using the AO/ASIF classification. Functional results were evaluated with the Mayo elbow performance score (MEPS) and the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score.

RESULTS

The overall mean arc of elbow motion was 108° (range 70°-140°) in the TRAP group, whereas that of the olecranon osteotomy group was 98° (range 70°-115°). A significant difference was observed between the two groups in terms of overall mean arc of elbow motion (p=0.038). There were no significant differences noted between the two groups in terms of mean MEPS and DASH scores (p=0.412, p=201, respectively). The overall complication rate was 27.2% in the TRAP group and 55% in the olecranon osteotomy group.

CONCLUSION

TRAP is a succesful approach in the treatmet of intra-articular distal humerus fractures that provides better arc of elbow motion, reduces complications and reoperation rates.