Surgical Treatment of Intercondylar Fracture of the distal Humerus through the Modified Triceps Sparing Approach

Lee, Han Jun; Kang, Soo Yong; Kang, Ki Ser; Lee, Sang Hack; Kim, Cheol Ho

Abstract

PURPOSE
We evaluated the therapeutic results of intercondylar fractures of the distal humerus that were treated through the modified tricepssparing approach. MATERIALS AND METHODS: From February, 1997 to september, 2001, we reviewed sixteen cases of intercondylar fracture of the distal humerus, which were treated by surgical treatment. The follow up period ranged from one year to three years, averaging 1 year 8 months. The articularsurface of the distal humerus was exposed through elevation of the triceps from the medial and the lateral intermuscular septum. Theulna nerve was identified and protected, and then, the fracture sites were fixed with double plates. The functional results were evaluated using Broberg and Morrey's functional scale. RESULTS: All united at 14.5 weeks in an average. The functional results were as follows; three excellent, ten good, two fair and one poor. The range of the elbow joint motion was flexion contracture 11 degree to further flexion 130 degree in average. The one patient presented poor result had coronal shear fracture of the capitulum combined with severe comminution. The incomplete ulnar nerve palsy developed in one case. CONCLUSION: The modified triceps sparing approach provided sufficient exposure for rigid fixation of intercondylar fracture of the humerus. But in cases with severe comminution or coronal shear fracture, additional anterior approach or olecranon osteotomy should be considered.