The anterior limited approach of the elbow for the treatment of capitellum and trochlea fractures: Surgical technique and clinical experience in eight cases

Ballesteros-Betancourt, J.R.; García-Tarriño, R.; García-Elvira, R.; Muñoz-Mahamud, Ernesto; Fernández-Valencia, Jenaro Á.; Llusá-Pérez, Manuel; Combalia-Aleu, A.

doi:10.1016/j.injury.2020.02.008

Cited by 13 publications

(18 citation statements)

References 26 publications

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“…Ravishankar et al [ 19 ] suggested that the lateral approach may cause laxity of the lateral collateral ligament, and the repair of the ligament during the operation will prolong the operation time. Ballesteros et al [ 10 ] suggested that due to the lack of operating space when using the lateral approach, the screw cannot be implanted perpendicularly to the fracture surface, which affects the fixation effect. The posterior approach may damage the blood supply to the posterior capitellum [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…To date, no unified opinion exists on the surgical approaches and fixation selection for the treatment of capitellar fractures [ 1 , 5 , 7 , 8 ]. The lateral and posterior approaches are the most commonly used surgical methods for elbow joint surgery [ 9 ], but for the treatment of capitellar fractures, the lateral and posterior approaches provide poor exposure to the fracture, which hinders fracture reduction and internal fixation [ 10 ]. This article retrospectively analyzes the clinical data of 15 adolescents and explores the effects of open reduction through the anterior approach and Herbert screw fixation for the treatment of capitellar fractures in adolescents.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Jiang

Yuan

et al. 2021

J Orthop Surg Res

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Objective The aim of this study is to analyze the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in adolescents. Methods We retrospectively analyzed the clinical and imaging data of 15 adolescents with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system. Results Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All adolescents completed a 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion Open reduction with Herbert screw fixation via the anterior approach is a feasible surgical method for the treatment of coronal fractures of the capitellum in adolescents. Levels of evidence Therapeutic, retrospective study-Level IV

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Jiang

Yuan

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…Ravishankar et al [19] suggests that the lateral approach may cause the laxity of the lateral collateral ligament, and the repair of the ligament during the operation will prolong the operation time. Ballesteros et al [10] suggests that due to the lack of operating space when using the lateral approach, the screw cannot be implanted perpendicularly to the fracture surface, which affects the xation effect. The posterior approach may damage the blood supply to the posterior capitellum [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…The lateral and posterior approach are the most commonly used surgical approaches for elbow joint surgery [9]. However, for the treatment of capitellar fractures, the lateral and posterior approaches provide poor exposure to the fracture, which hinders fracture reduction and internal xation [10]. This article retrospectively analyses the clinical data of 15 children and explores the effects of open reduction through the anterior approach and Herbert screw xation for the treatment of capitellar fractures in children.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Analysis of Herbert Screw Fixation for Capitellar Fractures via the Anterior Approach in Children

Li¹,

Jiang²,

Zhang³

et al. 2021

Preprint

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Objective: To analyse the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in children.Methods: We retrospectively analysed the clinical and imaging data of 15 children with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine the fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system.Results: Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All children completed 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion: Open reduction and Herbert screw fixation via the anterior approach are an ideal surgical method for the treatment of coronal fractures of the capitellum in children.Levels of Evidence: Therapeutic, retrospective study-Level IV

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“…The anterior (Henry) approach to the elbow has been widely used in upper limb surgery. It has been described as a valuable choice for the synthesis of proximal radial fractures, reinsertion of the distal biceps tendon, excision of anterior elbow tumors, and debridement in case of soft-tissue infections [23]. However, due to the anatomical characteristics of the area and because the elbow can be approached from other directions that involve lower surgical risk, the anterior approach is rarely used in everyday practice.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Posterior-anterior Approach and Lateral-medial Approach for Complex AO/OTA Type C Intra-articular Fractures of Distal Humerus

Chen¹,

Xiao²,

Chen

et al. 2021

Preprint

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Objective: The aim of this retrospective study was to investigate clinical effects of the treatment of intra-articular distal humeral fractures via the combined posterior olecranon osteotomy and anterior approach and the combined lateral Kaplan approach associated with the medial approach. Methods: Between July 2010 and September 2019, 28 cases of intercondylar fractures of the distal humerus (AO/OTA type C) were treated by open reduction and internal fixation (ORIF) via the posterior and anterior approach and combined lateral-medial approach, which were divided into the P-A (n = 13) and L-M (n = 15) groups, respectively. The outcomes in terms of function were assessed using the range of motion (ROM) of the elbow and forearm, humerotrochlear (HT) angle, Visual Analogue Scale (VAS) scores, Mayo Elbow Performance Score (MEPS), and efficacy grade evaluated using the scoring system of Orthopaedic Trauma Association (OTA) at the one-year follow-up. Results: The ﬂexion-extension of elbows and pronation-supination of forearms were respectively 114.1° ± 12.4° and 157.3° ± 9.6° in the P-A group and 117.1° ± 14.5° and 161.3° ± 10.7° in the L-M group. No significant diﬀerence was observed between the two groups for the elbow and forearm ROM (p > 0.05). Furthermore, surgery duration, blood loss volume, HT angle, MEPS, VAS scores, OTA rating, and the morbidity of postoperative complications during the one-year follow-up did not differ between groups. Conclusion: The posterior olecranon osteotomy and anterior approach can be used efficiently for exposure of complex distal humeral injuries with similar clinical efficacy and complications in the treatment of intra-articular distal humeral fractures as compared to the lateral-medial approach.

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The anterior limited approach of the elbow for the treatment of capitellum and trochlea fractures: Surgical technique and clinical experience in eight cases

Cited by 13 publications

References 26 publications

Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Therapeutic Analysis of Herbert Screw Fixation for Capitellar Fractures via the Anterior Approach in Children

Comparison of the Posterior-anterior Approach and Lateral-medial Approach for Complex AO/OTA Type C Intra-articular Fractures of Distal Humerus

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