Combined Olecranon Osteotomy and the Posterior Minimal Invasive Plate Osteosynthesis Approach for a Concomitant Injury of the Humeral Shaft and a Distal Intraarticular Humerus Fracture

Abstract

A complex fracture involving the distal humerus is a difficult fracture to treat and more so when it is involved with the ipsilateral shaft of the humerus. Open reduction and internal fixation of the humeral shaft with articular reconstruction have been described for a successful outcome of these complex fractures. However, it has drawbacks, especially in terms of soft tissue dissection and subsequent scarring and non-union.A 42-year-old female presented to the emergency department with a fracture of the intercondylar humerus with an ipsilateral shaft of the left humerus. Combined olecranon osteotomy with posterior minimal plate osteosynthesis was used to treat this fracture. At the one-year follow-up at the postoperative fracture clinic, there was no pain, the range of motion (ROM) of the elbow was 10 degrees to 140 degrees and the radiograph showed a healed fracture with the implant in situ.We present and review a novel technique to treat complex humerus fractures. Articular fragments can be directly visualized and fixed simultaneously. This approach allows for the biological fixation of the fracture and forms a reliable option for treating such complex fractures.

Olecranon osteotomy vs. triceps-sparing for open reduction and internal fixation in treatment of distal humerus intercondylar fracture: a systematic review and meta-analysis

“…Currently, the surgical operation with parallel or orthogonal plate fixation of the medial and lateral columns is widely used for patients with DHIF. [ 2 , 3 ] However, the drawbacks for the soft tissue dissection, subsequent scarring and non-union remain challenges for DHIF.…”