a Department of Orthopedic Surgery , Yiwu Central Hospital of Wenzhou Medical University , Yiwu , China.
b Department of Orthopedic Surgery , Ningbo Mingzhou Hospital , Ningbo , China.
Ann Med. 2017 Nov;49(7):613-625. doi: 10.1080/07853890.2017.1335429. Epub 2017 Jun 14.
Distal humerus intercondylar fractures are intra-articular comminuted fractures of the elbow that involve soft tissue injury. We evaluate different surgical approaches and elbow functional outcomes in the treatment of distal humerus fracture.
Medline, Cochrane, EMBASE, Google Scholar databases were searched up to 29 July 2016. All studies had to have evaluated the treatment of patients with intercondylar fractures of the distal humerus. The primary outcome was the incidence of functional grading of excellent/good.
The methods used to evaluate elbow function were diverse across the studies and included non-surgical, fixation and plating approaches. The most common surgical technique used was olecranon osteotomy (n = 7) and triceps-sparing (n = 5). In general, most procedures were associated with >70% of patients having excellent/good joint function following surgery. The meta-analysis included four studies with 276 patients, and compared olecranon osteotomy with triceps-sparing. The pooled analysis indicated that patients treated using olecranon osteotomy had better functional outcome than patients treated with triceps-sparing (pooled OR = 2.38, 95%CI: 1.25-4.55, p = .009).
This study found that a wide range of surgical procedures were effective in treating most patients with distal humerus intercondylar fractures, and that the approach of olecranon osteotomy may be more effective than that of triceps-sparing in restoring joint function. Key messages Most procedures in treating distal humerus intercondylar fractures were associated with >70% of patients having excellent/good joint function following surgery. The most common surgical technique used in treating distal humerus intercondylar fractures were olecranon osteotomy and triceps-sparing. The pooled analysis indicated that patients treated using olecranon osteotomy had better functional outcome than patients treated with triceps-sparing.
肱骨远端髁间骨折是肘部关节内粉碎性骨折，涉及软组织损伤。我们评估了不同的手术入路和肘部功能结果，以治疗肱骨远端骨折。
检索 Medline、Cochrane、EMBASE、Google Scholar 数据库，截至 2016 年 7 月 29 日。所有研究都必须评估治疗肱骨远端髁间骨折患者的情况。主要结果是功能分级优良的发生率。
研究中评估肘关节功能的方法多种多样，包括非手术、固定和钢板固定方法。最常用的手术技术是尺骨鹰嘴截骨术（n=7）和三头肌保留术（n=5）。一般来说，大多数手术都与>70%的患者术后关节功能良好/优良有关。荟萃分析包括四项研究共 276 例患者，比较了鹰嘴截骨术和三头肌保留术。汇总分析表明，鹰嘴截骨术治疗的患者功能结果优于三头肌保留术治疗的患者（汇总 OR=2.38，95%CI：1.25-4.55，p=0.009）。
本研究发现，治疗肱骨远端髁间骨折的多种手术方法均有效，其中鹰嘴截骨术可能比三头肌保留术更能有效恢复关节功能。
治疗肱骨远端髁间骨折的大多数手术方法术后>70%的患者关节功能良好/优良。治疗肱骨远端髁间骨折最常用的手术技术是鹰嘴截骨术和三头肌保留术。汇总分析表明，鹰嘴截骨术治疗的患者功能结果优于三头肌保留术治疗的患者。
