Inclusion of Olecranon Osteotomy With the Posterior Approach for Fixation of Distal Humerus Fractures (OTA/AO 13) Does Not Increase Surgical Complications
| Autor: | Ignacio G. Fleury, Michael C. Willey, Erin S. Wilson, John Davison, Grant Henning, Joseph A. Buckwalter |
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| Rok vydání: | 2021 |
| Předmět: |
Humeral Fractures
medicine.medical_specialty Olecranon medicine.medical_treatment Nonunion Distal humerus Osteotomy Ulnar neuropathy Cohort Studies Fracture Fixation Internal 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Elbow Joint medicine Humans Internal fixation Orthopedics and Sports Medicine Olecranon Process Range of Motion Articular Retrospective Studies 030222 orthopedics business.industry Trauma center 030208 emergency & critical care medicine General Medicine Humerus medicine.disease Surgery Treatment Outcome medicine.anatomical_structure business |
| Zdroj: | Journal of Orthopaedic Trauma. 35:e223-e227 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000002006 |
| Popis: | OBJECTIVES To determine if inclusion of an olecranon osteotomy to the posterior paratricipital approach for operative fixation of distal humerus fractures significantly affects surgical complication rates (OTA/AO 13). DESIGN Retrospective comparative cohort study. SETTING Level 1 trauma center. PATIENTS/PARTICIPANTS Three hundred four patients underwent open reduction internal fixation of a distal humerus fracture between 2007 and 2017. Of those, 134 met inclusion criteria (≥15 years, OTA/AO fracture type 13A, B, or C, and posterior surgical approach) for the study (n = 64 with olecranon osteotomy; n = 70 without olecranon osteotomy). INTERVENTION Open reduction internal fixation of distal humerus fractures performed using a posterior paratricipital approach with or without olecranon osteotomy. MAIN OUTCOME MEASURE Ulnar neuropathy (UN), fracture site bony nonunion, and surgical site infection (SSI). RESULTS Thirty-one (33.3%) who underwent the paratricipital approach without olecranon osteotomy, and 15 patients (26.8%) who underwent olecranon osteotomy reported postoperative UN with no significant difference between approaches (P = 0.438). There was no significant difference in rates of SSI (P = 0.418) or fracture site nonunion (P = 0.263) when comparing the approaches. Subjects with Charlson comorbidity index ≥2 were more likely to not undergo an olecranon osteotomy (P = 0.01), whereas subjects with more complex fractures by OTA/AO classification were more likely to have an olecranon osteotomy approach (P = 0.001). CONCLUSIONS Addition of an olecranon osteotomy with the paratricipital approach for fixation of distal humerus fractures does not result in higher rates of UN, fracture site nonunion, or SSI. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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