Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Abstract

Background: Distal humerus fractures had acquired an attention due to poor outcomes regardless of treatment modality which may be conservative or surgical. These fractures can be addressed with either triceps splitting or triceps sparing approach. The triceps sparing approach was performed by lateral window was developed on the lateral side of the triceps as it is elevated off the posterior border of the intermuscular septa and posterior humerus. Objective: The current work aimed to evaluate the outcome of surgical treatment of fracture distal humerus through triceps sparing approach. Patients and methods: A prospective, descriptive clinical study had been conducted at the Department of Orthopedic Surgery [Al Mataria Teaching Hospital, Egypt]. The study included 33 patients, and the average follow up was 12 months. The study completed from December 2018 to May 2020. Pain, clinical and radiological outcomes had been assessed and documented. Preoperatively, all patients had been clinically and radiologically evaluated. In addition, laboratory investigations had been performed to assess the fitness of the patient. Results: The study participants were 25 males and 8 females. Their age ranged between 30 and 55 years [mean age 43.09±7.93 years]. The mean quick Disabilities of the Arm, Shoulder and Hand [DASH] score was 18.3±3.3 points [ranged between 15 and 25]. The mean range of elbow flexion was 143.3 ± 3.9 degrees [135-145], while the mean range of elbow extension and contracture 8.6 ± 1.7 degrees [6-15] Conclusions: Triceps sparing avoids direct triceps injury with bloodless fields. However, a limited articular surface visualization of the distal humerus is an evitable drawback.

Keywords

• total elbow arthroplasty
• distal humerus
• fixation
• triceps sparing
• fractures