[Treatment of coronal shear fracture of the distal end of the humerus by the olecranon osteotomy approach].

OBJECTIVE:To explore the effectiveness of olecranon osteotomy approach for the treatment of coronal shear fracture of the distal end of the humerus. METHODS:A retrospective analysis was made on the clinical data of 34 patients with the coronal shear fracture of the distal end of the humerus treated by the olecranon osteotomy approach from January 2005 to January 2013. Of 34 cases, there were 15 boys and 19 girls, aged from 17 years to 84 years (mean, 54.9±10.2 years); 18 patients had fractures on the left and 16 patients had fractures on the right. Fractures were classified according to the Bryan and Morrey classification united Mckee classification: type Iinjuries occurred in 10 cases, type IIinjuries in 5 cases, type III injuries in 10 cases and type IV injuries in 9 cases. The Mayo elbow functional scores were evaluated for analysis. RESULTS:All the patients were followed up, and the duration ranged from 15 to 96 months, with a mean of (35.1±7.2) months. Average arc of motion was (132.1±11.2)° in flexion and (4.6±1.9)° in extension. The average Mayo score was 85.9±6.3(73 to 94 scores). Thirteen patients got an excellent result, 15 good and 6 poor. The average Mayo score was 88.6±3.7 in type Iinjuries, 85.8±4.6 in type IIinjuries, 81.8±5.8 in type III injuries and 87.5±9.1 in type IV injuries. There were no significant differences in outcomes. CONCLUSIONS:The treatment for the coronal shear fracture of the distal end of the humerus by the olecranon osteotomy approach can achieve the satisfactory curative effect, maintain the reduction and improve the elbow function.