title: The olecranon osteotomy provides better outcome than the triceps-lifting approach for the treatment of distal humerus fractures.
abstract: BACKGROUND
  Intra-articular distal humeral fractures can be approached in a variety of ways. The purpose of this study is to evaluate and compare the functional outcomes of two approaches: approach with olecranon osteotomy and triceps-lifting approach for the treatment of intra-articular distal humeral fractures.
  
  
  METHODS
  This study shows a consecutive series of 54 intra-articular distal humeral fractures of 54 patients who were treated with open reduction and internal fixation with anatomic plating. Lateral plating was performed in 10 (45.5 %) patients, and medial and lateral parallel plating was performed in 12 (54.5 %) patients in olecranon osteotomy group, while lateral plating was performed in 8 (25 %) patients, and medial and lateral parallel plating was performed in 24 (75 %) patients in triceps-lifting group.
  
  
  RESULTS
  Mean follow-up was 38.3 months for olecranon osteotomy group and 41.4 months for triceps-lifting group. Functional outcomes according to MAYO elbow score and extension-flexion motion arc values were significantly better in olecranon osteotomy group (p < 0.05).
  
  
  CONCLUSIONS
  Approach with olecranon osteotomy provided better functional outcomes than triceps-lifting approach. Additionally, intra-articular distal humerus fractures can be safely treated with olecranon osteotomy which provides more control over the elbow joint and better visualisation and allows early postoperative rehabilitation.
authors: Department of Orthopedics and Traumatology, Medical Faculty, Bezmialem Vakif University, Fatih, 34093, Istanbul, Turkey, drelmadag@hotmail.com.
authors: Mehmet
authors: M
authors: Elmadag
authors: Mehmet
authors: M
authors: Erdil
authors: Kerem
authors: K
authors: Bilsel
authors: Mehmet Ali
authors: MA
authors: Acar
authors: Nejat
authors: N
authors: Tuncer
authors: Ibrahim
authors: I
authors: Tuncay
mesh_terms: D000328:Adult; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D056740:Olecranon Process / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome