Rahul Singh1, Naman Kanodia2, Harveer Singh3. 1. Department of Orthopaedics, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India. Electronic address: rahulortho85@gmail.com. 2. Department of Orthopaedics, Sir Ganga Ram Hospital, New Delhi, India. 3. Department of Orthopaedics, GSVM Medical College, Kanpur, Uttar Pradesh, India.
Abstract
BACKGROUND: The paratricipital approach is a relatively new approach in a complex intra-articular fracture of distal humerus (AO13-C). The aim of this study was to ascertain this approach compared with the olecranon osteotomy approach. Also, we aimed to investigate whether advancing age and surgical delay yield a poor outcome. MATERIALS AND METHODS: Between 2011 and 2015, 51 adult patients with closed AO 13-C-type fractures were included in the study and divided into 2 groups, that is, paratricipital approach (PT) group and olecranon osteotomy (OO) group. Patients were treated by 2 senior trauma surgeons. They were prospectively analyzed for outcome and complications. Mayo elbow performance score (MEPS) was used to evaluate the outcome. RESULTS: Of the total 51 patients (mean age, 41.6 years), 27 patients were in the PT group and 24 in the OO group. There was no difference in arc of motion (P = .513) and MEPS (P = .127) as well as complication rate (χ2 statistic = 0.36, P = .54). However, specifically in the type C3 fracture, the PT group had a poor outcome for arc of motion (P = .002) and MEPS (P = .019) compared with the OO group. Also, age and surgical delay had a weak, negative correlation with arc of motion and MEPS. The association between age and surgical delay against arc of motion was statistically significant (P = .005 and .01, respectively). CONCLUSIONS: The PT approach and the OO approach can be used alternatively for AO 13-C1 and -C2 fractures with similar outcomes. However, in type C3, the PT approach yields a poor outcome in comparison with the OO approach.
BACKGROUND: The paratricipital approach is a relatively new approach in a complex intra-articular fracture of distal humerus (AO13-C). The aim of this study was to ascertain this approach compared with the olecranon osteotomy approach. Also, we aimed to investigate whether advancing age and surgical delay yield a poor outcome. MATERIALS AND METHODS: Between 2011 and 2015, 51 adult patients with closed AO 13-C-type fractures were included in the study and divided into 2 groups, that is, paratricipital approach (PT) group and olecranon osteotomy (OO) group. Patients were treated by 2 senior trauma surgeons. They were prospectively analyzed for outcome and complications. Mayo elbow performance score (MEPS) was used to evaluate the outcome. RESULTS: Of the total 51 patients (mean age, 41.6 years), 27 patients were in the PT group and 24 in the OO group. There was no difference in arc of motion (P = .513) and MEPS (P = .127) as well as complication rate (χ2 statistic = 0.36, P = .54). However, specifically in the type C3 fracture, the PT group had a poor outcome for arc of motion (P = .002) and MEPS (P = .019) compared with the OO group. Also, age and surgical delay had a weak, negative correlation with arc of motion and MEPS. The association between age and surgical delay against arc of motion was statistically significant (P = .005 and .01, respectively). CONCLUSIONS: The PT approach and the OO approach can be used alternatively for AO 13-C1 and -C2 fractures with similar outcomes. However, in type C3, the PT approach yields a poor outcome in comparison with the OO approach.
Authors: A Papen; T Schöttker-Königer; A Schäfer; F Morrison; B Hollinger; K J Burkhart; R Nietschke; A Zimmerer; N Maffulli; F Migliorini; Marco M Schneider Journal: J Orthop Surg Res Date: 2022-06-25 Impact factor: 2.677
Authors: Kimberley E Spierings; Bram J Schoolmeesters; Job N Doornberg; Denise Eygendaal; Michel Pj van den Bekerom Journal: Clin Shoulder Elb Date: 2022-04-04