Modified bilaterotricipital approach to the distal humerus: a triceps preserving technique

Dacombe, Peter; Clarke, Anna; Amirfeyz, Rouin

doi:10.1177/1758573216647908

Cited by 3 publications

(5 citation statements)

References 6 publications

(12 reference statements)

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“…It should be carried out by midline posterior incision with medial and lateral approach in the deeper planes. 13,17,26 The triceps muscle should be extensively released sometimes even up to the upper-thirds of humerus, protecting the radial nerve. 17,26 The common extensor origin may need to be detached.…”

Section: Treatmentmentioning

confidence: 99%

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Neglected posterior dislocation of elbow: A review

Pal

Mittal

Dinkar

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Untreated traumatic posterior dislocation of the elbow joint, 3 weeks or older, is defined as "neglected posterior dislocation of the elbow". Around 90% of these are of posterolateral type. These are much more common in the developing and underdeveloped countries. Patients presents with a deformed, stiff and painful elbow with difficulty to perform activities of daily living. The clinical picture looks quite similar to malunited supracondylar fracture of the elbow. Diagnosis is usually confirmed radiographically. CT and MRI scan give additional information and are recommended before embarking on surgery. Treatment is quite challenging due to the significant soft tissue contractures, ligamentous insufficiencies and fibrosis, with possible associated nerve injuries, myositis ossificans, non-compliant patients and the need for long-term postoperative physiotherapy. Goal of surgical treatment is to achieve a painless, stable and mobile elbow with a congruent joint space. We have reviewed the literature and present our view on the prognosis and recommended surgical technique to treat this condition.

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Section: Treatmentmentioning

confidence: 99%

“…13,17,26 The triceps muscle should be extensively released sometimes even up to the upper-thirds of humerus, protecting the radial nerve. 17,26 The common extensor origin may need to be detached. After tricepsplasty the elbow is usually unstable and would need stabilisation with either a transfixing pin or external fixator.…”

Section: Treatmentmentioning

confidence: 99%

Neglected posterior dislocation of elbow: A review

Pal

Mittal

Dinkar

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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“…The two techniques provided a good-enough access for fracture reduction, fixation and application of 90/90 or parallel fixation plates [8] .…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, ORIF was applied for 33 patients with distal humerus fractures through triceps-sparing approach. The mean elbow flexion was 140.45±3.82 degrees [135-145], and the mean elbow extension was 9.96±2.98 degrees [6][7][8][9][10][11][12][13][14][15]. Radiological outcome was achieved in all patients.…”

Section: Discussionmentioning

confidence: 99%

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Safy¹

2021

International Journal of Medical Arts

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Background: Distal humerus fractures had acquired an attention due to poor outcomes regardless of treatment modality which may be conservative or surgical. These fractures can be addressed with either triceps splitting or triceps sparing approach. The triceps sparing approach was performed by lateral window was developed on the lateral side of the triceps as it is elevated off the posterior border of the intermuscular septa and posterior humerus. Objective:The current work aimed to evaluate the outcome of surgical treatment of fracture distal humerus through triceps sparing approach.

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“…Our surgical approach is previously reported. 10 This is a triceps preserving approach alleviating the need for an olecranon osteotomy. The ulnar nerve was identified, decompressed but left in situ to avoid damage to vascularity of the nerve.…”

Section: Methodsmentioning

confidence: 99%

Does preservation of columns affect the medium-term outcome in distal humerus hemiarthroplasty for acute unreconstructable fractures?

et al. 2020

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Background We assessed distal humeral column preservation effects on clinical, radiographic and patient reported outcomes following distal humerus hemiarthroplasty for acute unreconstructable fractures. Methods Thirty-seven consecutive patients (mean age, 75; range, 29–93 years) with an average follow-up of 61 months (range, 24–105 months) after distal humerus hemiarthroplasty using a triceps preserving approach were studied. QuickDASH and Oxford Elbow Score assessed patient reported outcomes. Clinical and radiographic assessments comprised range of motion, grip strength, instability, implant loosening, chondral wear, heterotopic ossification and condylar union. Results Average QuickDASH was 14.9 (range, 0–63) and Oxford Elbow Score 40.35 (range, 25–48). Mean flexion arc was 108°, extension deficit 17° and pronosupination arc 155°. Average operative sided grip strength was 31.05 kg versus 31.13 kg contralaterally. Column preservation had no statistically significant effect on QuickDASH ( p = 0.75), Oxford Elbow Score ( p = 0.78), flexion–extension ( p = 0.87), pronosupination ( p = 0.78) or grip strength ( p = 0.87). No progressive radiographic loosening or symptomatic chondral wear occurred. All fixed columns united. Three cases of immediate post-operative laxity fully resolved on elbow mobilisation. Four post-operative complications required further surgery: one ulnar neuropathy, one heterotopic ossification, one wound breakdown and one traumatic dislocation. Conclusion Medium-term outcome of distal humerus hemiarthroplasty for acute unreconstructable distal humeral fractures is reliable irrespective of condylar preservation.

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Modified bilaterotricipital approach to the distal humerus: a triceps preserving technique

Cited by 3 publications

References 6 publications

Neglected posterior dislocation of elbow: A review

Neglected posterior dislocation of elbow: A review

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Does preservation of columns affect the medium-term outcome in distal humerus hemiarthroplasty for acute unreconstructable fractures?

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