Abstract
Aim: To compare the functional outcome as well as elbow range of motion (ROM) after triceps splitting and triceps sparing approach for AO/OTA TYPE A distal humerus fractures. Materials and Methods: This is a prospective study done at our center between 2011 and 2014. A total of 50 patients presented with extra articular distal humerus fracture (AO/OTA 13 A2, 13A3). Exclusion criteria removed 16 patients from the study while 2 patients died due to medical comorbidities before the final follow up. Out of the remaining 32 patients, they were divided into two groups: triceps splitting (15 patients) and triceps sparing (17 patients). Elbow ROM, along with Disabilities of the Arm, Shoulder and Hand questionnaire scores, was compared between the two groups. Results: Triceps sparing group had greater elbow flexion (140.0 ± 4.0) compared to triceps splitting group (126.0 ± 10.0) with p Conclusion: As compared to triceps splitting approach, triceps sparing approach results in better elbow ROM with less extension contracture, however both approaches result in similar functional outcome.
Highlights
Triceps sparing approach avoids direct injury to the triceps and uses bloodless planes and this is the primary reason for improved elbow range of motion (ROM) and less post operative elbow contracture seen after this approach as compared to triceps splitting approach which involves splitting of the muscle and denervating a portion of the muscle
Emmanuel et al [8] compared the outcomes after triceps splitting versus triceps sparing approach in extra articular distal humerus fractures (AO/OTA TYPE A) and they reported better elbow ROM and triceps strength with triceps sparing approach as compared to triceps splitting approach
During 2011-2014, 50 patients presented with extra articular distal humerus fracture. 16 patients were excluded from the study
Summary
Extra articular distal humerus fractures can be tackled via both triceps splitting. Remia et al [3] compared triceps splitting versus triceps sparing approach and they found no statistically significant difference in elbow ROM and triceps deficit. Emmanuel et al [8] compared the outcomes after triceps splitting versus triceps sparing approach in extra articular distal humerus fractures (AO/OTA TYPE A) and they reported better elbow ROM and triceps strength with triceps sparing approach as compared to triceps splitting approach. Both these approaches had similar functional outcome as per DASH scores
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