Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus

PURPOSE: To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus. MATERIALS AND METHODS: Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM. RESULTS: The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks. CONCLUSION: Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.

Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating

PURPOSE: To analyze the results of operative treatment for Comminuted Fracture of Distal Humerus with Transolecranon approach and Orthogonal plating. MATERIALS AND METHODS: The subjects were 22 patients with Comminuted fracture of humerus who were treated with Orthogonal plating. Patient's age, sex, type of fracture, surgical approach, method of fixation, time of operation, time of bony union, complication, range of motion were investigated, and Function of elbow was evaluated by functional evaluation of Riseborough and Radin, Mayo Elbow Performance Score (MEPS). RESULTS: Age, sex, injuried arm, operation time were not related to postoperative result. Type C2 fractures showed better results in function and range of motion (ROM) than type C3 fractures. Also early rehabilitation was important to functional recovery and ROM. The postoperative ROM was average 110. Good were 16 cases, fair were 6 cases in functional evaluation of Riseborough and Radin. Excellent were 13 cases, good were 8 cases, fair was 1 case in MEPS. CONCLUSION: Operative treatment with Transolecranon approach and Orthogonal plating showed favorable result on its function. Intraarticular comminution and early rehabilitation were closely related to postoperative function of elbow.

Clinical Outcome of Surgical Treatment of Distal Humerus Intercondylar Fractures Through the Transolecranon Approach Combined with Anterior Transposition of the Ulnar Nerve

PURPOSE: To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve. MATERIALS AND METHODS: Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate. RESULTS: The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy. CONCLUSION: We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar fractures