The clinical efficacy of olecranon osteotomy approach and bilateral approach through triceps brachii for the treatment of intercondylar humeral fractures / 中华骨科杂志

ABSTRACT

ObjectiveSystematically evaluate the clinical efficacy and complications of olecranon osteotomy and bilateral approach through triceps brachii for the treatment of intercondylar humeral fractures. MethodsTo search the domestic and foreign literatures published from January 1980 to March 2008 about the treatment of intercondylar humeral fractures, which use olecranon osteotomy approach and bilateral ap-proach through triceps brachii. Systematically evaluate these literatures using the methods of systematic re-view provided by the Cochrane collaboration. ResultsAfter the screening and evaluation to the literatures, 33 published literatures that met the inclusive criteria of this study were collected. There were a total of 876 cases of patients whose follow-up data was integrity (olecranon osteotomy approach group for 509 cases;bilat-eral approach through triceps brachii group for 367 cases) and these cases had provided the postoperative scores of elbow joint function. The excellent and good rates of postoperative score of elbow joint function for the type C2 and C3 fracture patients in the olecranon osteotomy approach group were 82.32% and 79.38% respectively; while those in the bilateral approach through triceps brachii group were 70.59% and 64.71% respectively. The former was significantly higher than the latter. The excellent and good rate of the type C1 fracture patients between two approaches groups showed no statistical significant. Fourteen literatures provid-ed the data about postoperative complications, the incidence of complications of patients that received ole-cranon osteotomy approach was 4.72%(95%CI 4.70%-4.74%), and the results also showed that compared with bilateral approach through triceps brachii (8.17%, 95%CI 8.13%-8.21%). ConclusionTo treat inter-condylar humeral fractures, postoperative efficacy of olecranon osteotomy approach is better than that of the bilateral approach through triceps brachii. Using olecranon osteotomy approach can get adequate exposure, easy open reduction and internal fixation, quick recover and less complication.