title: Anconeus pedicle olecranon flip osteotomy: an approach for the fixation of complex intra-articular distal humeral fractures.
abstract: In order to achieve satisfactory reduction of complex distal humeral fractures, adequate exposure of the fracture fragments and the joint surface is required. Several surgical exposures have been described for distal humeral fractures. We report our experience using the anconeus pedicle olecranon flip osteotomy approach. This involves detachment of the triceps along with a sliver of olecranon, which retains the anconeus pedicle. We report the use of this approach in ten patients (six male, four female) with a mean age of 38.4 years (28 to 51). The mean follow-up was 15 months (12 to 18) with no loss to follow-up. Elbow function was graded using the Mayo Score. The results were excellent in four patients, good in five and fair in one patient. The mean time to both fracture and osteotomy union was 10.6 weeks (8 to 12) and 7.1 weeks (6 to 8), respectively. We found this approach gave reliably good exposure for these difficult fractures enabling anatomical reduction and bicondylar plating without complications.
authors.affiliation: RML Hospital and PGIMER, Department of Orthopedic Surgery, New Delhi, 110001, India.
authors.forename: M
authors.initials: M
authors.lastname: Habib
authors.affiliation: RML Hospital and PGIMER, Department of Orthopedic Surgery, New Delhi, 110001, India.
authors.forename: Y S
authors.initials: YS
authors.lastname: Tanwar
authors.affiliation: Bokaro General Hospital, Bokaro, Jharkhand, India.
authors.forename: A
authors.initials: A
authors.lastname: Jaiswal
authors.affiliation: RML Hospital and PGIMER, Department of Orthopedic Surgery, New Delhi, 110001, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Singh
authors.affiliation: RML Hospital and PGIMER, Department of Orthopedic Surgery, New Delhi, 110001, India.
authors.forename: S
authors.initials: S
authors.lastname: Sinha
authors.affiliation: RML Hospital and PGIMER, Department of Orthopedic Surgery, New Delhi, 110001, India.
authors.forename: H
authors.initials: H
authors.lastname: Lal
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Anconeus pedicle; Distal Humerus fractures; Olecranon osteotomy