Passive Physiotherapy Research Articles

Treatment of Calcific Tendinitis around the Elbow

Purpose: This study was performed to evaluate surgical outcomes in calcific tendinitis around the elbow due to persistent pain despite conservative treatment.Methods: The study retrospectively reviewed seven consecutive patients who visited Jeju National University Hospital due to pain around the elbow and underwent operative treatment due to persisting calcific lesion evidenced by radiographs and ultrasonography. The patients’ mean age was 40 years, and the average follow-up was 5 years and 10 months. Surgical procedures were performed under brachial plexus block anesthesia to remove calcific deposits at the common extensor tendon with incision around the lesion along with repair of partially ruptured tendons during the removal using nonabsorbable sutures. The patients were immobilized with a long-arm splint in a neutral position for 2 weeks after operation, followed by rehabilitation involving continuous passive motion and physical therapy for elbow joint range of motion and muscle strengthening, respectively. Intraoperative biopsy revealed inflammatory cells and microcalcification indicative of calcific tendinitis in all patients. Surgical outcome was evaluated based on patient’s subjective satisfaction under five-point grading scale, Mayo Elbow Performance Index (MEPI) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score.Results: The patient’s subjective satisfaction scale revealed “very satisfactory” in three cases and “satisfactory” in four cases. The median MEPI and DASH score were preoperatively 45 and 88.8, which improved to 85 and 36.2 at final follow-up, respectively.Conclusion: In patients with persistent pain despite aggressive conservative treatment in calcific tendinitis, direct surgical removal of calcific deposit is an effective way to resolve symptom and prevent recurrence.

The distally based dorsal metacarpal artery flap (DMCA)

Regional flap for the reconstruction of combined skin and soft-tissue defects of the fingers or the distal parts of the palm. Full-thickness soft-tissue defects of the fingers dorsally up to the distal interphalangeal joint, of the fingers palmarly up to the middle phalanx, or of the distal parts of the palm. Damage of the dorsal metacarpal artery or of the distal anastomosis by trauma or previous operation. Ongoing infections. Preoperative Doppler examination. Planning of aflap using the proximal or distal anastomosis of the metacarpal artery with the palmar system as its pivot point. Raising of an adipofascial flap including as many veins as possible. Alternatively, the metacarpal artery can be raised alone as afascial flap. Tension-free insertion of the flap into the defect. To avoid venous congestion, we do not recommend subcutaneous tunneling of the flap. The skin bridge should be incised instead. Loose cotton dressing, periodic monitoring, bed rest for 5days. After 3days active and passive physiotherapy can start. Suture removal after 14days. Reliable and relatively secure flap with aflap loss rate up to 20% in literature. The donor site can be closed primarily up to aflap width of 2 cm. The fourth metacarpal artery is missing in up to 30% of the cases.

Autonomous Patient-Controlled Mobilization Protocol After Flexor Tendon Repair: A Case Series.

Despite many publications on rehabilitation after repair of flexor tendon injuries of the hand, there is no consensus as to which method is superior. It is clear that nonadherence to postoperative therapy adversely affects the outcome after flexor tendon surgery. In the context of a developing country, the most important factor associated with poor outcome is late onset of rehabilitation therapy. An autonomous rehabilitation program is proposed, with the use of a low-cost splint and based on an online illustrative video with the expectation to improve adherence and patient compliance, thus ensuring satisfactory outcome. Twenty-two consecutive digits of 14 patients after flexor tendon repair in zone II were included. Autonomous early passive mobilization physical therapy and splinting started shortly after surgery, supported by an online available video depicting prescribed exercises; follow-up was continued until postoperative week 20. Patients were evaluated regarding range of motion, grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) disability scale. Range of motion after 20 weeks according to the scoring system of the American Society of Surgery of Hand was excellent in 4, good in 11, and fair in 4 fingers. The mean total active motion score was 86% (95% confidence interval, 78%-93%). The mean grip strength at final follow-up was 86% of the contralateral hand. The mean QuickDASH score was 12.5 (2.3-31.8). This protocol achieves good results in range of motion and early return of function of the hand. We propose this simple, nonexpensive method to developing countries with less than optimal availability of health care.

Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial.

The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach’s main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.

Management of Leprosy in the Context of COVID-19 Pandemic: Recommendations by SIG Leprosy (IADVL Academy).

Management of Leprosy in the Context of COVID-19 Pandemic: Recommendations by SIG Leprosy (IADVL Academy).

Stroke care in 1960 and now–the case of René Maugras

Background/ObjectiveGeorges Simenon accurately describes, in a novel called Les Anneaux de Bicêtre, the clinical picture and course, and the hospital procedures and treatment of a patient with a large left hemispheric stroke, presumably ischemic. MethodsI here summarize these features and use them as a basis to discuss the marked changes in stroke evaluation and care in the last 60 years. Results/Case ReportA 54-year old Newspaper director was admitted shortly after an acute stroke leading to temporary loss of consciousness, to motor aphasia and right hemiplegia and hypoesthesia. Risk factors included hypertension, a sedentary life, smoking, and a previous episode of cardiac arrhythmia possibly related to congenital heart disease. Evaluation included electroencephalography, cerebral arteriography and cerebrospinal fluid analysis. The acute treatment involved prolonged bed rest in a private room, prophylactic antibiotics, and oral anticoagulation. Smoking was allowed. Prolonged in-hospital rehabilitation followed initial passive physical therapy provided by nurses. After many months, the patient was released with persistent motor problems and a marked psychological change. ConclusionThe entire field of acute stroke care has been revolutionized in the last 60 years. Big data management, telemedicine, software, new brain and vascular imaging techniques, biomarkers, robotics etc., are currently in development and again should lead to new and surprising changes during the next decades.

Tensiomyography detects early hallmarks of bed-rest-induced atrophy before changes in muscle architecture.

In young and older people, skeletal muscle mass is reduced after as little as 7 days of disuse. The declines in muscle mass after such short periods are of high clinical relevance, particularly in older people who show a higher atrophy rate and a slower or even a complete lack of muscle mass recovery after disuse. Ten men (24.3 yr; SD 2.6) underwent 35 days of 6° head-down tilt bed rest, followed by 30 days of recovery. During bed rest, a neutral energy balance was maintained, with three weekly passive physiotherapy sessions to minimize muscle soreness and joint stiffness. All measurements were performed in a hospital at days 1-10, 16, 28, and 35 of bed rest (BR1-BR10, BR16, BR28, and BR35, respectively) and days 1, 3, and 30 after reambulation (R + 1, R + 3, and R + 30, respectively). Vastus medialis obliquus (VMO), vastus medialis longus (VML), and biceps femoris (BF) thickness (d) and pennation angle (Θ) were assessed by ultrasonography, whereas twitch muscle belly displacement (Dm) and contraction time (Tc) were assessed with tensiomyography (TMG). After bed rest, d and Θ decreased by 13-17% in all muscles ( P < 0.001) and had recovered at R + 30. Dm was increased by 42.3-84.4% ( P < 0.001) at BR35 and preceded the decrease in d by 7, 5, and 3 days in VMO, VML, and BF, respectively. Tc increased only in BF (32.1%; P < 0.001) and was not recovered at R + 30. TMG can detect early bed-rest-induced changes in muscle with higher sensitivity before overt architectural changes, and atrophy can be detected. NEW & NOTEWORTHY Detection of early atrophic processes and irreversible adaptation to disuse are of high clinical relevance. With the use of tensiomyography (TMG), we detected early atrophic processes before overt architectural changes, and atrophy can be detected using imaging technique. Furthermore, TMG detected irreversible changes of biceps femoris contraction time.

Discussion on traditional Chinese medicine treatment models of depression named "three phases, five internal organs and ten syndromes"

Based on the inheritance, the research group summarized the transmissive pathogenesis of depression in three typical stages, formulating the stepward treatment units which included Chinese medicine, acupuncture and TCM characterized psychotherapy, and formed a sequential treatment plan that balanced the principle of strengthening healthy Qi to eliminate pathogens, active and passive treatment, physical therapy and psychotherapy. Based on the retrospective analyses, ten typical clinical have been formed, constituting the pattern differentiation of Three Phases, Five internal organs and Ten syndromes for depression, which sysmatically showed the TCM syndrome differentiation. This work promoted the experiences and methods of treating depression by Chinese medicine. Key words: Depression; Traditional Chinese medicine; Three phases, Five internal organs and Ten syndromes; Staging syndrome differentiation; Spirits of five Zang viscera

Abstract P-303: EFFICACY OF REFLEX LOCOMOTION TO PREVENT OSTEOPENIA IN PRETERM INFANTS

Aims & Objectives: Preterm infants have a lower level of bone mineralization compared to those born at term. Passive physiotherapy has been effective in the treatment of osteopenia, but active mobilizations can be more effective than passive ones. In this sense, Vojta’s reflex locomotion therapy allows stimulation of central nervous system, causing muscle contraction. The aim of this study is to determine if Vojta therapy is effective in the prevention of osteopenia in preterm infants. Methods 46 premature infants with gestational age (GA) ≤34 weeks were randomly assigned to three groups: experimental group 1 (EGV, N=17), experimental group 2 (EGMP, N=14) and control group (CG, N=15). For 30 days EGV received Vojta therapy, EGMP passive mobilizations with joint pressure and CG massage techniques. A quantitative ultrasound device measured changes in bone density. Two evaluations were carried out: before the treatments and at the end of the treatments. Results There were no significant differences between the groups in GA, birth weight and gender distribution. ANOVA of two partially repeated measures factors was performed, comparing the treatment group and the tibial sound velocity (TSV) results. Our results show that there is no significant interaction of the factor “type of intervention” in the variable TSV, F(2,39)=2.457, p=0.098, n2=0.103; although they show a difference of means between the EGV and the EGMP and CG of 11.3 and 11.9 points respectively Conclusions Although the results do not reveal significant differences between the groups comparing TSV, they show a remarkable tendency, obtaining better results the EGV.

Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial

BackgroundThe elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country. Options include early- or delayed motion supervised by a physical therapist, immediate continuous passive motion (CPM), (night) splinting and a static progressive or dynamic splinting program.Methods/designThe SET-Study (Stiff Elbow Trial) is a single-centre, prospective, randomized controlled trial. The primary objective of this study is to compare the active Range of Motion (ROM) (flexion arc and rotational arc) twelve months after surgery between three groups. The first group will receive in-hospital CPM in combination with early motion Physical Therapy (PT) supervised by a physical therapist, the second group will receive only in-hospital early motion PT supervised by a physical therapist and the third group will receive outpatient supervised PT from postoperative day seven till ten. Secondary outcome measures will be Patient Reported Outcome Measures (PROMs) including the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), the quick Disabilities of Arm, Shoulder and Hand (qDASH) score, Visual Analogue pain Scale in rest and activity (VAS), Pain Catastrophizing Scale (PCS), the Short Form (SF)-36, the Centre for Epidemiological Studies Depression Scale Revised (CESD-R) and the Work Rehabilitation Questionnaire (WORQ) for the upper limb.DiscussionA successful completion of this trial will provide evidence on the best rehabilitation protocol in order to (re)gain optimal motion after surgical release of the stiff elbow.Trial registrationThe trial is registered at the Dutch Trial Register: NTR6067, 31–8-2016.

Back Schools for chronic non-specific low back pain.

Back Schools for chronic non-specific low back pain.

Fisioterapia pasiva para el tratamiento del síndrome de fibromialgia. Una revisión sistemática

ObjectivesTo review the most recent literature on the effects of passive physiotherapy in the treatment of fibromyalgia, including the different techniques used and the measurement of their effectiveness on each symptom. Search strategya bibliographic search was carried out in PubMed database to locate clinical trials conducted in the previous five years. Study selectionOf the 683 studies found, 18 of them were selected and assessed according to their methodological quality using the PEDro scale. Summary of resultspassive physiotherapy could be an effective treatment, since techniques such as electrotherapy, balneotherapy, and myofascial release improve pain and quality of life in the subjects. Depression is improved by manual therapy and balneotherapy. Transcutaneous electrical nerve stimulation (TENS) and manual therapy improve sleep. ConclusionsPassive physiotherapy could be an effective symptomatic treatment. The choice of the technique must depend on the specific symptom required to be treat.

Pneumatic Muscle Actuated Rehabilitation Equipment of the Upper Limb Joints

Rehabilitation equipment of the upper limb joints holds a key role in passive physical therapy. Within this framework, the paper presents two such pieces of equipment developed for the rehabilitation of elbow and of wrist and knuckles, respectively. The presented and discussed equipment is actuated by pneumatic muscles, its benefits being a low cost, simple and robust construction, as well as short response time to commands.

Tratamento conservativo para hiperextensão tibiotársica bilateral em cão – relato de dois casos

Tibiotarsal joint hyperextension is a hereditary pathology of rare incidence in companion animals, which affects the pelvic limbs. It is characterized by hyperextension of tibiotarsal joint, as well as by difficulty in flexing the affected limb. In some cases it can also affect the knee joint. Treatment choice and prognosis are critically dependent on early diagnosis, which increases favorable results. A Yorkshire Terrier pup and a Schnauzer pup with locomotion deficiency in the pelvic limbs were diagnosed with tibiotarsal joing hyperextension. Conservative treatment with passive and active physiotherapy and bandages was started, and provided good functional recovery without the need of surgical intervention.

Management strategies on venovenous extracorporeal membrane oxygenation

The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) for severe acute respiratory failure (ARF) has considerably increased worldwide. Therefore, extracorporeal membrane oxygenation (ECMO) teams called for practical guidelines with clear objectives on how to manage ECMO on daily basis.1 All classical topics of intensive care management have been put in perspective with the use of ECMO, opening multiple areas of research. Good teamwork is the central pillar of any ECMO program. After starting an ECMO run, the medical team has to deal with a triangle including the patient, the ECMO machine, and their interaction. This unique interdependence makes the management challenging, as any change occurring on one side (patient or ECMO) will affect the other side. The priority is to diagnose and treat the cause of ARF. Bronchoscopy showed a reasonable safety for diagnostic yield and clearing airways. The optimization of the oxygen delivery is primordial within the acute period and is represented by matching the ECMO flow and the cardiac output, maintaining an adapted level of hemoglobin, and decreasing causes of high oxygen consumption.2 The management of volume status is essential for keeping a precise balance between the patient and the machine. Echocardiography is an essential tool that provides much information before cannulation on hemodynamic, access insufficiency once the patient is on ECMO, initial cannula positioning or readjustment, and finally tolerance to ECMO weaning before and after decannulation.3 Once ECMO provides adequate oxygenation delivery for the patient, the different parameters of mechanical ventilation have to be readjusted with an actual trend to decrease most of them: FiO2 (25%), inspiratory pressure (10 cm H2O), and respiratory rate (10 cycles/min) that results in ultra-protective lung ventilation with an expected tidal volume in a range of 1–3 ml/kg.4 More than knowing the “best” positive end expiratory pressure, a low driving pressure less than 1 cm H2O has to be targeted.5 This is to ensure that the lungs can rest and recover over time. The exact duration required to reach these settings to allow an improvement on oxygenation is unpredictable. The weaning process is challenging as the gas exchange function improvement and the lung compliance recovery are sometimes not concomitant. It requires daily monitoring to allow early extubation while on ECMO. The anticoagulation has to be balanced not only to avoid any clots in the circuit when just connected, but also to avoid any bleeding. Analgesia and sedation are important for the initial oxygen consumption after cannulation and have to be minimized from the second day to the third day. The goal is for the patient to receive sufficient oxygenation without pain. Depending on their tolerance, patients will sometimes be awake while on ECMO. Then, an active physiotherapy (PT) program including mobilization, sitting on the edge of the bed, standing up, and walking should follow the passive PT started from the first day on ECMO. Acute renal failure is common during ECMO and should be prevented and treated with renal replacement therapy. Many other points including nutritional support and nosocomial infection prevention are specifically integrated in the patient management. In summary, the management strategies on VV-ECMO are complex and require to master critical care and ECMO knowledge combined with a strong collaborative multidisciplinary environment. The goal is to wean patients from ECMO as soon as clinical parameters permit it while avoiding ECMO-related complications.

Resistance training concomitant to radiotherapy of spinal bone metastases - survival and prognostic factors of a randomized trial.

PurposeTo compare the effects of resistance training versus passive physical therapy on bone survival in the metastatic bone during radiation therapy (RT) as combined treatment in patients with spinal bone metastases. Secondly, to evaluate overall survival and progression-free-survival (PFS) as well as to quantify prognostic factors of bone survival after combined treatment.MethodsIn this randomized trial 60 patients were allocated from September 2011 until March 2013 into one of the two groups: resistance training (group A) or passive physical therapy (group B) with thirty patients in each group during RT. We estimated patient survival using Kaplan-Meier survival method. The Wald-test was used to evaluate the prognostic importance of pathological fracture, primary site, Karnofsky performance status, localization of metastases, number of metastases, and cerebral metastases.ResultsMedian follow-up was 10 months (range 2–35). Bone survival showed no significant difference between groups (p = .303). Additionally no difference between groups could be detected in overall survival (p = .688) and PFS (p = .295). Local bone progression was detected in 16.7 % in group B, no irradiated bone in group A showed a local progression over the course (p = 0.019). In univariate analysis breast cancer, prostate cancer, and the presence of cerebral metastases had a significant impact on bone survival in group B, while no impact could be demonstrated in group A.ConclusionsIn this group of patients with spinal bone metastases we were able to show that guided resistance training of the paravertebral muscles had no essential impact on survival concomitant to RT. Importantly, no local bone progression in group A was detected, nevertheless no prognostic factor for combined treatment could be evaluated.Trial registrationClinical trial identifier NCT 01409720. Registered 8 February 2011.

Biochemical markers of bone turnover in patients with spinal metastases after resistance training under radiotherapy--a randomized trial.

BackgroundTo compare the effects of resistance training versus passive physical therapy on bone turnover markers (BTM) in the metastatic bone during radiation therapy (RT) in patients with spinal bone metastases. Secondly, to evaluate an association of BTM to local response, skeletal-related events (SRE), and number of metastases.MethodsIn this randomized trial, 60 patients were allocated from September 2011 to March 2013 into one of the two arms: resistance training (Arm A) or passive physical therapy (Arm B) with thirty patients in each arm during RT. Biochemical markers such as pyridinoline (PYD), desoxy-pyridinoline (DPD), bone alkaline phosphatase (BAP), total amino-terminal propeptide of type I collagen (PINP), beta-isomer of carboxy-terminal telopeptide of type I collagen (CTX-I), and cross-linked N-telopeptide of type I collagen (NTX) were analyzed at baseline, and three months after RT.ResultsMean change values of PYD and CTX-I were significantly lower at 3 months after RT (p = 0.035 and p = 0.043) in Arm A. Importantly, all markers decreased in both arms, except of PYD and CTX-I in arm B, although significance was not reached for some biomarkers. In arm A, the local response was significantly higher (p = 0.003) and PINP could be identified as a predictor for survivors (OR 0.968, 95%CI 0.938–0.999, p = 0.043). BAP (OR 0.974, 95%CI 0.950–0.998, p = 0.034) and PINP (OR 1.025, 95%CI 1.001–1.049, p = 0.044) were related with an avoidance of SRE.ConclusionsIn this group of patients with spinal bone metastases, we were able to show that patients with guided resistance training of the paravertebral muscles can influence BTM. PYD and CTX-I decreased significantly in arm A. PINP can be considered as a complementary tool for prediction of local response, and PINP as well as BAP for avoidance of SRE.Trial registrationClinical trial identifier NCT 01409720. August 2, 2011.

Peripheral Neuropathy Following Spinal Anaesthesia after DHS Fixation Surgery for Inter-trochanteric Fracture Femur

Background: Proximal femoral fractures present unique challenges for anaesthetic department involving the peri-operative care of large numbers of older patients with significant co-morbidities. The majority (95%) of hip fractures occur in patients over the age of 60. 75% occurring in females. More than 98% of fractures are repaired surgically, for the purposes of analgesia and early rehabilitation. Peripheral neuropathy following spinal anaesthesia is a rare complication following lower limb surgery. Purpose: To ensure proper safety measures while giving spinal anaesthesia to the patients. Multiple attempts and faulty technique may lead to direct trauma to the spinal cord or nerve root. Material and Methods: 79 yrs old female presented to OPD with complaints of pain over left hip and unable to walk. X-ray showed IT fracture femur. Patient was admitted, investigated and fitness was taken. DHS fixation surgery was performed under spinal anaesthesia. Post-operatively patient developed DVT of the operated leg and neuropathy (loss of movement but intact sensation) of the contra-lateral leg. Low molecular weight Heparin was started for DVT along with elastic stocking to the limb and MRI was done to assess the cause for peripheral neuropathy. Outcome: Though rare, peripheral neuropathy is a complication of spinal anaesthesia. Damage to nerve roots can occur due to faulty technique or repeated attempts for spinal anaesthesia. Prolonged hypotension following spinal anaesthesia may cause spinal cord ischemia or thrombosis of the anterior spinal artery leading to flaccid paraplegia. Conclusion: Continuous passive physiotherapy of the lower limbs helps in complete recovery of the neuropathy but at a slow rate.

Physiotherapy for Patients on Awake Extracorporeal Membrane Oxygenation: A Systematic Review.

Extracorporeal membrane oxygenation (ECMO) is used as temporary life support in subjects with potentially reversible respiratory/cardiac failure. The principal purpose of this review was to assess the characteristics and potential advantages of physiotherapeutic interventions in subjects on awake ECMO support. Seven databases were interrogated: we searched titles, abstracts and keywords using the Medical Subject Headings terms 'extracorporeal membrane oxygenation' and 'rehabilitation' linked with the Boolean operator 'AND'. In total, 216 citations were retrieved. Nine citations satisfied our inclusion criteria and were subjected to full-text analysis. The numbers of patients enrolled in the included studies (most of which were case series) were low (n = 52). We found no prospective studies or randomized controlled trials. Overall, subjects on awake ECMO usually received a combination of passive and active physiotherapy, and most achieved an acceptable degree of autonomy after treatment. Emerging research in the field affords preliminary evidence supporting the safety of early mobilization and ambulation in patients on awake veno-venous ECMO support. Copyright © 2015 John Wiley & Sons, Ltd.

Cannulated Screw and Wire Fixation with Predrilling for Olecranon Osteotomy in Intra-articular Comminuted Distal Humerus Fractures

Purpose: The olecranon osteotomy in intra-articular comminuted distal humerus fractures is a suggested technique for excellent exposure of articular fractures. However, complications including delayed union, nonunion of osteotomy site have been reported. Authors have applied predrilling for cannulated screw before osteotomy for achievement of rapid and accurate reposition of separation part and added wire fixation for secure stability. The purpose of this study is to evaluate the efficacy of this fixation procedure following the olecranon osteotomy during the internal fixation of intra-articular fracture of the distal humerus. Materials and Methods: This study retrospectively analyzed 14 cases (9 women and 5 men) of intra-articular distal humerus fractures in which the olecranon osteotomy was applied. The mean age of patients was 53.4 years (range, 25 to 83 years), and the average follow-up period was 15.9 months. Eleven cases were classified as AO 13-C3, and the other 3 cases were AO 13-C2. Reduction accuracy, union period of osteotomy site on follow-up radiographs and postoperative complications related to olecranon osteotomy were evaluated. Results: All osteotomized parts showed no position change and solid union with normal alignment at the last follow-up. The mean period of bony union was 3.5 months (range, 2 to 5 months). There were no complications related to olecranon osteotomy except one case of non-displaced fracture of the proximal ulnar shaft at the level of cannulated screw tip caused by forceful passive physical therapy. It was managed by conservative treatment without further problem. Conclusion: Predrilled cannulated screw and wire fixation following the olecranon osteotomy during internal fixation of intra-articular comminuted distal humerus fractures showed satisfactory results in the union of osteotomy site and it could be a recommendable procedure when fractures require olecranon osteotomy.