Clinical comparison of management of intra-articular distal humerus fractures with two surgical approaches; TRAP vs Olecranon osteotomy

Abstract

Background: The aim of this study is to evaluate and compare the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy. Methods: Thirty three patients with intra-articular distal humerus fractures were retrospectively analysed. TRAP approach was used in 17 patients (10 males, 7 females; mean age 35.9 years, range 17-70), and olecranon osteotomy in 16 patients (11 males, 5 females; mean age 34.4 years, range 18-62). Fractures were classified using the AO/ASIF classification. Functional results were evaluated with the Mayo elbow performance score (MEPS) and the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score. Results: The overall mean arc of elbow motion was 108° (range 70°-140°) in the TRAP group, whereas that of the olecranon osteotomy group was 102° (range 70°-130°). There were no significant differences noted between the two groups in terms of mean MEPS and DASH scores (p=0.318, p=0.236, respectively). The overall complication rate was 41.17% in the TRAP group and 56.25% in the olecranon osteotomy group. Conclusion: Intra-articular distal humerus fractures mandates surgical fixation for best functional outcomes. Both TRAP and olecranon osteotomy approaches can be used in the treatment of intra-articular distal humerus fractures. Both approaches yields no significant difference in clinical and functional results for intra-articular distal humerus fracture management.