Giuseppe Rollo1, Roberto Rotini2, Denise Eygendaal3, Paolo Pichierri1, Michele Bisaccia4, Ante Prkic5, Alessandro Stasi1, Luigi Meccariello6. 1. Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy. 2. Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy. 3. Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. 4. Orthopaedics and Traumatology Unit, Department of Surgical and Biomedical Science, S.M. Misericordia Hospital, University of Perugia, Perugia, Italy. 5. Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands. 6. Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy. Electronic address: drlordmec@gmail.com.
Abstract
BACKGROUND: Anatomic surgical reduction of intra-articular fractures of the distal humerus is important to achieve the best long-term outcomes and prevent post-traumatic arthritis. In this study we compared the radiographic reduction using the trochleocapitellar index. We also correlated the trochleocapitellar index to the functional outcomes next to the comparison of the triceps brachii lifting approach and olecranon osteotomy approach, 2 common approaches for distal humeral fractures. METHODS: From January 2006 to June 2016, patients with elbow fractures were registered in 4 centers. The trochleocapitellar index, a ratio between the angle of the capitellum and the trochlea to the midline of the distal humerus on anterior-posterior radiographs, was calculated for included patients. Functional outcomes were measured using the Oxford Elbow Score and the Mayo Elbow Performance Score. Bone healing was measured using radiographic union scoring. RESULTS: There were 86 patients enrolled: 46 in the olecranon osteotomy group and 40 in the triceps lifting group. Functional outcomes and bone healing did not differ between the approaches. Functional results had a medium correlation with the trochleocapitellar index, which did not differ between the 2 approaches (olecranon osteotomy group, κ = 0.56; triceps lifting group, κ = 0.57; P = .7932). CONCLUSIONS: The trochleocapitellar index has a moderate predictive value on the functional results after 12 months after open reduction and internal fixation of intra-articular distal humeral factures. There is no difference in reduction, as measured by trochlear index and functional outcome scores, between the olecranon osteotomy approach and the triceps brachii lifting approach groups.
BACKGROUND: Anatomic surgical reduction of intra-articular fractures of the distal humerus is important to achieve the best long-term outcomes and prevent post-traumatic arthritis. In this study we compared the radiographic reduction using the trochleocapitellar index. We also correlated the trochleocapitellar index to the functional outcomes next to the comparison of the triceps brachii lifting approach and olecranon osteotomy approach, 2 common approaches for distal humeral fractures. METHODS: From January 2006 to June 2016, patients with elbow fractures were registered in 4 centers. The trochleocapitellar index, a ratio between the angle of the capitellum and the trochlea to the midline of the distal humerus on anterior-posterior radiographs, was calculated for included patients. Functional outcomes were measured using the Oxford Elbow Score and the Mayo Elbow Performance Score. Bone healing was measured using radiographic union scoring. RESULTS: There were 86 patients enrolled: 46 in the olecranon osteotomy group and 40 in the triceps lifting group. Functional outcomes and bone healing did not differ between the approaches. Functional results had a medium correlation with the trochleocapitellar index, which did not differ between the 2 approaches (olecranon osteotomy group, κ = 0.56; triceps lifting group, κ = 0.57; P = .7932). CONCLUSIONS: The trochleocapitellar index has a moderate predictive value on the functional results after 12 months after open reduction and internal fixation of intra-articular distal humeral factures. There is no difference in reduction, as measured by trochlear index and functional outcome scores, between the olecranon osteotomy approach and the triceps brachii lifting approach groups.
Authors: Luigi Meccariello; Vincenzo Caiaffa; Konrad Mader; Ante Prkic; Denise Eygendaal; Michele Bisaccia; Giuseppe Pica; Sonia Utrilla-Hernando; Roberta Pica; Giuseppe Rollo Journal: Strategies Trauma Limb Reconstr Date: 2022 May-Aug