title: Outcome of olecranon osteotomy in the trans-olecranon approach of intra-articular fractures of the distal humerus.
abstract: BACKGROUND
  The trans-olecranon approach has been suggested to improve the visualization of complex intra-articular distal humerus fractures. Significant osteotomy complications have prompted a search for alternative approaches. The purpose of this series was to study the outcome of the olecranon osteotomy in terms of union and complications and the ultimate outcome of the fracture.
  
  
  METHODS
  Ninety-four patients with intra-articular fractures of the distal humerus (type C3) were treated by open reduction and internal fixation using the trans-olecranon approach. The patients were followed from 6 to 48 months, with an average follow-up of 24 months.
  
  
  RESULTS
  All osteotomies united in an average of 11 weeks (range, 8-20 weeks). There was no non-union, although union was delayed in four osteotomies, which all healed by 20 weeks without any intervention. The most frequent complication in this study was symptomatic osteotomy fixation in 19% of patients, all of whom underwent a secondary procedure for the removal of the implant after the osteotomy had united. Seventy-one percent of the unsatisfactory results were seen in those patients who had symptomatic olecranon fixation.
  
  
  CONCLUSIONS
  Despite a few manageable complications, the trans-olecranon approach is essential for the adequate visualization and fixation of the complex fracture of the distal humerus. Adequate fixation of the osteotomy is essential to prevent complications and achieve a satisfactory outcome.
authors.affiliation: Department of Orthopaedics, Government Medical College Srinagar, University of Kashmir, Kashmir, India. shafaatrashid@gmail.com
authors.forename: Shafaat Rashid
authors.initials: SR
authors.lastname: Tak
authors.forename: Gh Nabi
authors.initials: GN
authors.lastname: Dar
authors.forename: Manzoor Ahmed
authors.initials: MA
authors.lastname: Halwai
authors.forename: Khursheed Ahmed
authors.initials: KA
authors.lastname: Kangoo
authors.forename: Bashir Ahmad
authors.initials: BA
authors.lastname: Mir
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult