Intercondylar fractures of the distal humerus treated with the triceps-reflecting anconeus pedicle approach

Özer, Hamza; Solak, Sukru; Turanli, Sacit; Baltaci, Gül; Colakoglu, Tugrul; Bölükbaşı, Selçuk

doi:10.1007/s00402-005-0026-0

Cited by 43 publications

(16 citation statements)

References 17 publications

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“…The TRAP approach is extensile enough in treating complex humeral fractures. Both articular reconstruction and fixation can be easily managed without creating an olecranon fracture 15. The repair is easy and strong enough to allow a rapid rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of intercondylar fractures of the humerus using triceps reflecting anconeus pedicle (TRAP) approach

Pankaj¹,

Mallinath²,

Malhotra³

et al. 2007

Indian J Orthop

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Background:Operative fixation of intra-articular fractures of the distal humerus requires adequate exposure. The transolecranon approach is a commonly used approach. The olecranon osteotomy has potential complications related to prominence/migration of hardware, displacement/nonunion of osteotomy and triceps weakness. Triceps-reflecting anconeus pedicle (TRAP) approach avoids the olecranon osteotomy without compromising the operative exposure. We present outcome of fixation of displaced intra-articular distal humeral fractures with the use of TRAP approach.Materials and Methods:We reviewed the functional and radiological results of 40 consecutive patients with intercondylar fractures of the humerus treated by internal fixation through TRAP approach. There were 28 males and 12 females and the average age was 32 ± 4.5 years. The right elbow was involved in 27 patients and the left elbow in 13 patients. The mechanism of injury was a fall in 20 patients, a motor-vehicle accident in 16 patients and direct trauma in four patients.Results:At a minimum follow-up of 12 months (average 18 ± 4 months) 35 (87.5%) patients had good triceps strength. The average range of motion was 118.4 ± 7 degrees (range 80°-130°). The average time to union was 3.2 ± 1.6 months (range two to six months). No patient had triceps rupture, implant failure, neurovascular deficit or nonunion. Two patients needed removal of the implant because of subcutaneous prominence.Conclusions:The TRAP approach provides good visualization for fixation of intercondylar fractures of the humerus, without any noticeable untoward effect on triceps strength and postoperative rehabilitation; and one can avoid iatrogenic fracture of the olecranon and its associated complications.

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Section: Discussionmentioning

confidence: 99%

Surgical management of intercondylar fractures of the humerus using triceps reflecting anconeus pedicle (TRAP) approach

Pankaj¹,

Mallinath²,

Malhotra³

et al. 2007

Indian J Orthop

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“…These complications include delayed union, wound dehiscence, nonunion, malunion, hardware failure, and pain secondary to prominent hardware (Table 1). Alternative approaches to avoid these complications have been reported during the last years, such as the triceps-splitting [9, 18], triceps-reflecting anconeus pedicle [15, 19], the anconeus-flap transolecranon approach [20], and the triceps-sparing approach [21]. …”

Section: Introductionmentioning

confidence: 99%

Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach

et al. 2013

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Several alternative approaches have been described to avoid the complications related to the olecranon osteotomy used to treat distal articular humerus fractures. The published experience with the triceps-sparing approach is scant. In this prospective study, a total of 12 patients with an articular humeral fracture were treated using this approach. At a mean followup of 1,7 years, the average range of motion was 112.8° (range from 85° to 135°); the elbow flexion averaged 125.5° (range from 112° to 135°) and the deficit of elbow extension 14.6° (range from 0° to 30°). All the elbows were stable. The Mayo Elbow Performance Score (MEPS) averaged 93.3 (range from 80 to 100). In the present series no failure of the triceps reattachment to the olecranon was found, and all the patients recalled returning to their previous daily life activities without impairment with a satisfactory MEPS. As a conclusion, the triceps-sparing approach can be considered for treating distal articular humerus fractures. We consider that three clinical settings can be more favorable to use this approach: those cases in which a total elbow prosthesis might be needed, cases of ipsilateral diaphyseal fracture, or presence of previous hardware in the olecranon.

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“…9,31,37,40 Thus, controversy remains regarding the optimal approach for use in surgical management of these fractures. Various approaches have their own proponents, with Pollock et al 28 recommending olecranon osteotomy for AO type C distal humeral fractures, Ek et al 14 and Qi et al 30 both recommending a BryanMorrey approach, and Ozer et al 26 advocating for the TRAP approach. The purpose of our study was to systematically review the existing literature that compares functional outcomes after ORIF of closed, intra-articular distal humeral (AO type C) fractures by the surgical approach used to determine whether, from an evidencebased standpoint, one approach is associated with a superior functional outcome over another.…”

mentioning

confidence: 98%

Effects of surgical approach on functional outcomes of open reduction and internal fixation of intra-articular distal humeral fractures: a systematic review

Ljungquist

Beran

Awan

2012

Journal of Shoulder and Elbow Surgery

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Intercondylar fractures of the distal humerus treated with the triceps-reflecting anconeus pedicle approach

Cited by 43 publications

References 17 publications

Surgical management of intercondylar fractures of the humerus using triceps reflecting anconeus pedicle (TRAP) approach

Surgical management of intercondylar fractures of the humerus using triceps reflecting anconeus pedicle (TRAP) approach

Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach

Effects of surgical approach on functional outcomes of open reduction and internal fixation of intra-articular distal humeral fractures: a systematic review

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