Does Surgical-approach Affect Outcome After Fixation of Intra-articular Fractures of Distal Humerus?

Study Overview
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Brief Summary
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observational study at tertiary care hospital and level 1 trauma centre aiming to evaluate the difference between two common surgical approaches to distal humerus fracture fixation.

Detailed Description
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Fractures around the distal humerus fractures make up to 2% of all fractures. Complex intra-articular distal humerus fractures present as challenge to restore of painless, stable and mobile elbow joint. Surgical exposure to all critical structures is of paramount importance to achieve anatomic reduction. Conflict still persists regarding the choice of ideal approach between triceps-sparing approach compared with olecranon osteotomy approach. In this study investigators compare the effect of surgical approach triceps lifting vs olecranon osteotomy on the functional outcome after fixation of distal humerus intra-articular fractures. Investigators conducted a non-funded, non-commercial, retrospective cohort study on participants with closed distal humerus intra-articular fractures between 2010 and 2015 at our tertiary care level-1 trauma and university hospital. Participants >18 years of age with closed complex intra-articular distal humerus fracture were operated using two different surgical approaches, either triceps lifting approach (Group1) or with olecranon osteotomy (Group 2). Functional evaluation of the participant is carried out with quick DASH scores at the final 1 year follow-up. Investigators concluded that triceps lifting approach can be used equally efficiently for exposure of these complex distal humerus injuries with no comprise in visibility of articular fragments.

Official Title
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Surgical Approach for Distal Humerus Fracture

Conditions
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Distal Humerus Fracture

Intervention / Treatment
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* Procedure: triceps lifting and olecranon osteotomy approaches


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients >18 years of age with closed complex intra-articular distal humerus fracture (Intercondylar Fracture Riseborough Radin Classification type lll and lV) were included. Exclusion Criteria: Patients with CVA (Cerebero-Vascular Accident), dementia and associated with neurovascular injuries which may impede with rehabilitation are excluded
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| (Group1)<br>Triceps lifting approach . | Procedure: triceps lifting and olecranon osteotomy approaches<br>* two different surgical approaches for distal humerus fracture<br>|
| (Group 2)<br>olecranon osteotomy approach | Procedure: triceps lifting and olecranon osteotomy approaches<br>* two different surgical approaches for distal humerus fracture<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional outcome using Quick DASH Score | Disabilities of Arm, Shoulder & Hand | 1 years followup | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intra-articular fractures; distal humerus; osteotomy; elbow joint