Para-tricipital approach for extra articular fractures of the distal humerus: a case series

Authors

  • Rasiq Rashid Department of Orthopaedics, SKIMS MCH, Srinagar, Jammu and Kashmir, India
  • Imtiyaz Ahmad Beigh Department of Orthopaedics, SKIMS MCH, Srinagar, Jammu and Kashmir, India
  • Shahid Shabir Khan Department of Orthopaedics, SKIMS MCH, Srinagar, Jammu and Kashmir, India
  • Reyaz Ahmad Dar Department of Orthopaedics, SKIMS MCH, Srinagar, Jammu and Kashmir, India
  • Saheel Maajid Department of Orthopaedics, SKIMS MCH, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20234055

Keywords:

Para tricipital, Triceps sparing, Adequate exposure, VAS, Extra articular, Humerus fracture

Abstract

Extra-articular fractures of the distal humerus are frequently managed surgically as these fractures are often unstable and have associated radial nerve injury. Different surgical approaches can be used to fix this fracture. We operated on a series of 9 patients with extra-articular fractures of the distal humerus utilizing the para-tricipital approach. Clinical outcomes were assessed by Mayo elbow performance score and visual analog scores. Radiological outcomes were assessed by plain radiographs. Time to union was an average of 4.2 months. Mean range of motion achieved at final follow-up was 122.50. Mean Mayo elbow performance score was 92.4. Excellent clinical results can be achieved by utilizing para-tricipital approach in extra-articular fractures of the distal humerus. Besides providing adequate exposure for rigid fracture fixation, this approach prevents the morbidity associated with triceps injury.

References

Sharma S, John R, Dhillon MS, Kishore K. Surgical approaches for open reduction and internal fixation of intra-articular distal humerus fractures in adults: A systematic review and meta-analysis. Injury. 2018;49(8):1381-91.

Trikha V, Agrawal P, Das S, Gaba S, Kumar A. Functional outcome of extra-articular distal humerus fracture fixation using a single locking plate: A retrospective study. J Orthop Surg. 2017;25(3).

Acuna J, Hahn B. Holstein Lewis humerus fracture. Am J Emerg Med. 2016;34(2):e345.5-6.

Singh V, Hayes H, Kazemi N, Dey S, Parikh S. The Holstein-Lewis humerus shaft fracture in children: are they different from adults? J Pediatr Orthop. 2022;31(3):274-80.

Patiño JM, Rullan Corna AF, Abdon IM, Michelini AE, Mora Pulido DA. Paratricipital approach for distal humerus fractures. Musculoskelet Surg. 2021;105(2):155-160.

Parmaksızoğlu AS, Özkaya U, Bilgili F, Mutlu H, Çetin Ü. Fixation of extra-articular distal humeral fractures with a lateral approach and a locked plate: an alternative method. Acta Orthop Traumatol Turc. 2016;50(2):132-8.

Alonso-Llames M. Bilaterotricipital Approach to the Elbow: Its Application in the Osteosynthesis of Supracondylar Fractures of the Humerusin Children, Acta Orthopaedica Scandinavica. 1972;43(6):479-90.

Prasarn ML, Ahn J, Paul O, Morris EM, Kalandiak SP, Helfet DL, Lorich DG. Dual plating for fractures of the distal third of the humeral shaft. J Orthop Trauma. 2011;25(1):57-63.

Scolaro JA, Voleti P, Makani A, Namdari S, Mirza A, Mehta S. Surgical fixation of extra-articular distal humerus fractures with a posterolateral plate through a triceps-reflecting technique. J Shoulder Elbow Surg. 2014;23(2):251-7.

Schildhauer TA, Nork SE, Mills WJ, Henley MB. Extensor mechanism-sparing paratricipital posterior approach to the distal humerus. J Orthop Trauma. 2003;17(5):374-8.

Downloads

Published

2023-12-29