Treatment of Intercondrlar Fracture of Elbow using Y-Plate through Extraartieular Olecranon Osteotomy in the Posterior Approach

Chang, Ho Guen; Lee, Sang Su; Lee, Eung Ju; Chang, Jun Dong; Cho, Won Ho; Lee, Chang Ju

Abstract

Iniercondylar fractures of the distal humerus in adults are rare and notoriously difficult to treat. We treated 8 patients by open reduction and internal fixation using Y-plate with extraarticular olecranon osteotomy in posterior approach. L-shaped osteotomy was performed at the extraarticular portion of olecranon with triceps tendon insertian remained to proximal portion of it, using air-saw. The follow-up period ranged from 12 to 30 months with average of 19.7 months. The fractures were dassified according to AO classification. The results were evaluated using Jupiter et al grading system. 1) There was no loosening of fixation Cevice of humeral condyle and olecranon. 2) Niether delayed union nor nonunion of olecranon and humeral condyle were found. 3) Exellent grade was achieved in 4 patients(50%), three(38%) had good, and one(12%) poor. Flexion-extension arc ranged from 60 degree to 120 degree with mean of 98.8 degree. 4) Complications included postoperatile neuritis in one, myositis ossificance in one, and heterotopic bone in one patient. Authors would introduce the method and result of extraarticular olecranon osteotomy in posterior approach for the intercondylar fracture of distal humerus, as a new technique.