title: Surgical fixation of extra-articular distal humerus fractures with a posterolateral plate through a triceps-reflecting technique.
abstract: BACKGROUND
  Surgical management of extra-articular distal humerus fractures results in predictable fracture alignment. Open reduction and internal fixation also decrease the soft tissue complications and frequent follow-up required with functional bracing. A triceps-reflecting posterior approach provides excellent exposure to the humerus and minimizes trauma to the triceps. An anatomically precontoured plate on the posterolateral surface of the humerus provides stable fixation of these injuries and is placed directly through the interval developed by the triceps-reflecting approach.
  
  
  METHODS
  We retrospectively reviewed the trauma databases at 2 level I academic trauma institutions during a 5-year period for all patients with an extra-articular distal humerus fracture treated with a triceps-reflecting approach and an anatomically precontoured posterolateral distal humerus plate. Patient and fracture characteristics were recorded, as were QuickDASH functional scores and visual analog scale scores for pain, function, and quality of life.
  
  
  RESULTS
  Forty patients were eligible for our study. Average follow-up was 88 weeks. Thirty-eight (95%) patients went on to union. Seven (20%) patients required a secondary procedure. The average QuickDASH score was 17.5 (range, 2.6-56.8). The average visual analog scale scores were 1.9 (range, 0-7) for pain, 2.3 (range, 0-8) for function, and 1.6 (range, 0-5) for quality of life. Thirty-five (87.5%) patients reported satisfaction with the outcome of their surgery.
  
  
  CONCLUSIONS
  Surgical fixation of extra-articular distal humerus fractures through a triceps-reflecting approach with an anatomically precontoured posterolateral distal humerus plate results in predictable osseous union and overall excellent functional results for patients with this injury.
authors: University of California - Irvine, Irvine, CA, USA.
authors: John A
authors: JA
authors: Scolaro
authors: University of Pennsylvania, Philadelphia, PA, USA.
authors: Pramod
authors: P
authors: Voleti
authors: University of Pennsylvania, Philadelphia, PA, USA.
authors: Amun
authors: A
authors: Makani
authors: Rothman Institute, Philadephia, PA, USA.
authors: Surena
authors: S
authors: Namdari
authors: Oregon Health and Science University, Portland, OR, USA.
authors: Amer
authors: A
authors: Mirza
authors: University of Pennsylvania, Philadelphia, PA, USA. Electronic address: samir.mehta@uphs.upenn.edu.
authors: Samir
authors: S
authors: Mehta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Case Series; Humeral fracture; Level IV; Treatment Study; distal humerus; extra-articular; posterolateral plate; triceps reflecting