Evaluation on effect of three surgical approaches in treatment of type C fracture of distal humerus

Objective To study the clinical efficacy of three surgical approaches, the osteotomy of olecranon, the triceps tongue-shaped flap and the bilateral triceps approach in treatment of type C fracture of distal humerus. Methods A retrospective study was conducted on 45 cases of type C fracture of distal humerus, who were treated with three surgical approaches from Jan. 2005 to Dec. 2012. Fifteen patients were treated with the osteotomy of olecranon, 14 patients were treated with the triceps tongue-shaped flap, 16 patients were treated with the bilateral triceps approach. The operation time,bleeding volume and postoperative elbow functional exercise time were compared between three groups. Results There were significant differences in operation time, bleeding volume, and postoperative elbow functional exercise time between three groups(P 0.05). There were significant differences in the Mayo scores and ROM between the triceps tongue-shaped flap group and the osteotomy of olecranon group and the bilateral triceps approach group(P 0.05). There were no significant differences in the Mayo scores and ROM between the osteotomy of olecranon group and the bilateral triceps approach group(P0.05). Conclusion Application of the osteotomy of olecranon and the triceps tongue-shaped flap for distal humerus fracture has advantages of fully revealing the surgical field, but has shortcomings of greater trauma,longer operative time, more late postoperative elbow functional exercise time. Conversely, application of the bilateral triceps approach has advantages of smaller trauma, shorter operative time, less bleeding, earlier postoperative elbow functional exercise time. but there were certain restrictions on the surgical field revealing.