title: Comparison of lateral and posterior surgical approach in management of extra-articular distal humeral shaft fractures.
abstract: OBJECTIVE
  The objective of this study was to compare treatment results and complication rates between lateral and posterior approaches in surgical treatment of extra-articular distal humeral shaft fractures.
  
  
  METHODS
  Between June 2008 and May 2012, a total of 68 patients with extra-articular distal humeral shaft fractures were treated by lateral and posterior approaches. Of the patients, 30 were operated by a lateral approach (group I) and 26 patients were operated by a posterior approach (group II). There was no statistical significance between the two groups in sex distribution, age, the mechanism of the injury, injured arms, AO/ASIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation) classification, and the time from injury to surgery (P>0.05). Operation time, intraoperative bleeding volume, hospitalisation, clinical outcomes, and complications were compared between the two groups. The elbow functional results were evaluated by the Mayo Elbow Performance Score (MEPS).
  
  
  RESULTS
  All patients were followed up. The average of follow-up in group I was 15.53±2.636 months (range, 12-22 months), and was 16.12±2.889 months (range, 12-22 months) in group II. There was no significant difference in the operation time, intraoperative bleeding time, and hospitalisation between the two groups (P>0.05). In group I, the mean time of bone union was 12.87±1.852 weeks (range, 10-16 weeks), the mean degrees of elbow flexion was 139.20°±3.274° (range, 134-146°), the mean degrees of elbow extension was 4.77°±1.906° (range, 0-8°), and the mean points of MEPS was 87.00±7.724 (range, 70-100 points). In group II, the mean time of bone union was 12.96±2.218 weeks (range, 10-16 weeks), the mean degrees of elbow flexion was 137.85°±4.076° (range, 130-145°), the mean degrees of elbow extension was 5.15°±2.327° (range, 0-9°), and the mean points of MEPS was 86.15±7.656 (range, 70-100 points). There was no significant difference in the bone union, range of elbow flexion, range of elbow extension and MEPS between the two groups (P>0.05). The overall complication rate in group I was lower than that in group II (P=0.041).
  
  
  CONCLUSIONS
  Both lateral and posterior surgical approaches acquired satisfied treatment results in the management of extra-articular distal humeral shaft fractures, and there was a lower complication rate using the lateral approach.
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China; Medical College, Nankai University, No. 94 Weijin Road, Tianjin 300071, PR China. Electronic address: yinpeng3904@126.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Yin
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Mao
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Yanpeng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Tao
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Xiangdang
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China.
authors.forename: Houchen
authors.initials: H
authors.lastname: Lv
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China; Medical College, Nankai University, No. 94 Weijin Road, Tianjin 300071, PR China.
authors.forename: Tongtong
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, PR China. Electronic address: pftang301@sina.cn.
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Complication; Distal humeral shaft; Fractures; Lateral approach; Posterior approach