Comparative study of olecranon osteotomy and bilateral triceps brachii approach for the treatment of type C3 distal humerus fracture / 新乡医学院学报

ABSTRACT

Objective To compare the clinical effect between olecranon osteotomy and bilateral triceps brachii approach combined with bilateral locking plate in the treatment of type C3 distal humerus fracture.Methods Forty-five patients with type C3 distal humerus fracture were performed with operation and follow-up in Department of Osteology of the First People's Hospital of Xinxiang City from July 2006 to February 2016.The patients were divided into olecranon osteotomy group (n =25) and bilateral triceps brachii approach group (n =20).The patients in olecranon osteotomy group were treated with olecranon osteotomy combined with bilateral locking plate,and the patients in bilateral triceps brachii approach group were treated with bilateral triceps brachii approach combined with bilateral locking plate.The incision length,operation time,hospitalization time,fracture healing time,postoperative complications and the score of elbow joint function were compared between the two groups.Results There was no significant difference in the mean follow-up time between the two groups (P ＞ 0.05).The incision length in olecranon osteotomy group was significantly shorter than that in bilateral triceps brachii approach group(P ＜ 0.05).There was no significant difference in the operation time,hospitalization time and fracture healing time between the two groups (P ＞ 0.05).There was one case of infection and two cases of heterotopic ossification in the olecranon osteotomy group,and the incidence of postoperative complications was 12.0％ (3/25).There was one case of heterotopic ossification,one case of fracture delayed union and one case of elbow joint stiffness in the bilateral triceps brachii approach group,and the incidence of postoperative complications was 15.0％ (3/20).There was no significant difference in the incidence of postoperative complications between the two groups (x2 =0.087,P ＞ 0.05).At the end of the follow-up,the excellent rate of the Mayo score of elbow joint function in the olecranon osteotomy group and bilateral triceps brachii approach group was 88.0％ (22/25) and 55.0％ (11/20) respectively,the excellent rate in the olecranon osteotomy group was significantly higher than that in the bilateral triceps brachii approach group (x2 =6.188,P ＜ 0.05).Conclusion Compared with the bilateral triceps brachii approach,the olecranon osteotomy combined with bilateral locking plate fixation is more beneficial to the recovery of elbow joint function in patients with type C3 distal humerus fracture.