Extra-articular and Intra-articular Olecranon Osteotomy in the Treatment of Patients with Intercondylar Fractures of the Distal Humerus_West China Medical Journal

Authors：

 LUOZhong-chun , LIUKai , SONGChun-lin , ZHONGLang ,  JIANGJun-wei

Department of Orthopedics, People's Hospital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding?author：

JIANGJun-wei, Email: 285061643@qq.com

Keywords：

Extra-articular osteotomy; Intra-articular osteotomy; Intercondylar fractures of the distal humerus; Clinical outcome

DOI：

10.7507/1002-0179.20150006

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Objective To compare extra-articular and intra-articular olecranon osteotomy in treating intercondylar fractures of the distal humerus managed with open reduction and internal fixation regarding the functional outcomes and complications. Methods Between September 2008 and December 2010, 36 patients with intercondylar fractures of the distal humerus were treated by open reduction and internal fixation using the trans-olecranon approach. Among the, 21 underwent extra-articular olecranon osteotomy and 15 accepted intra-articular olecranon osteotomy. The mean follow-up time was three years. We compared the elbow function, the rate of no non-union or delayed union and the rate of postoperative complications between the two groups. Results The elbow function and Mayo elbow performance scores were good at the latest follow-up. There was no non-union in all osteotomies. We found significant difference in delayed union (P=0.01) and traumatic arthritis rate (P=0.02) between the two groups. Conclusion Extra-articular olecranon osteotomy is better for bone union and the decrease of traumatic arthritis rate.

Citation： LUOZhong-chun, LIUKai, SONGChun-lin, ZHONGLang, JIANGJun-wei. Extra-articular and Intra-articular Olecranon Osteotomy in the Treatment of Patients with Intercondylar Fractures of the Distal Humerus. West China Medical Journal, 2015, 30(1): 26-29. doi: 10.7507/1002-0179.20150006 Copy

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2.	Gainor BJ, Moussa F, Schott T. Healing rate of transverse osteotomies of the olecranon used in reconstruction of distal humerus fractures[J]. J South Orthop Assoc, 1995, 4(4):263-268.
3.	王振威, 徐建高, 常林順.經尺骨鷹嘴關節外斜行截骨治療肱骨髁間骨折[J].中華創傷骨科雜志, 2006, 8(7):681-682.
4.	張喜海, 徐楊博, 卓乃強, 等.復雜肱骨遠端骨折內固定失敗相關因素分析及對策[J].中國骨與關節損傷雜志, 2010, 25(2):176-177.
5.	Tian D, Jing J, Qian J, et al. Comparison of two different double-plate fixation methods with olecranon osteotomy for intercondylar fractures of the distal humeri of young adults[J]. Exp Ther Med, 2013, 6(1):147-151.
6.	王永才, 王紅川, 樓華, 等.經尺骨鷹嘴截骨雙側鎖定加壓鋼板內固定治療C型肱骨遠端骨折[J].中國修復重建外科雜志, 2013, 27(11):1404-1405.
7.	林紹儀, 劉金偉.經尺骨鷹嘴截骨入路雙側平行鋼板固定治療肱骨遠端關節內骨折[J].中國骨與關節損傷雜志, 2013, 28(1):86-87.
8.	顧海倫, 楊軍, 丁立峰, 等.尺骨鷹嘴截骨結合雙鋼板技術治療肱骨髁間粉碎性骨折[J].中華創傷雜志, 2013, 29(5):407-410.
9.	田大勝, 荊玨華, 周云, 等.尺骨鷹嘴截骨雙鋼板內固定治療青壯年C型肱骨髁間骨折[J].創傷外科雜志, 2013, 15(3):226-229.
10.	Mckee MD, Kim J, Kebaish K, et al. Functional outcome after open supracondylar fractures of the humerus. The effect of the surgical approach[J]. J Bone Joint Surg Br, 2000, 82(5):646-651.
11.	Gofton WT, Macdermid JC, Patterson SD, et al. Functional outcome of AO type C distal humeral fractures[J]. J Hand Surg Am, 2003, 28(2):294-308.
12.	吳英華, 張鐵良, 金碩, 等.經尺骨鷹嘴關節外斜行截骨治療肱骨髁間骨折[J].中華骨科雜志, 2005, 25(8):472-475.
13.	劉小坡, 劉德群, 劉會仁, 等.經尺骨鷹嘴入路關節外斜行截骨對血供影響解剖學觀察[J].中國臨床解剖學雜志, 2008, 26(4):363-365.
14.	Schmidt-Horlohe K, Wilde P, Bonk A, et al. One-third tubular-hook-plate osteosynthesis for olecranon osteotomies in distal humerus type-C fractures:a preliminary report of results and complications[J]. Injury, 2012, 43(3):295-300.
15.	劉會仁, 劉小坡, 劉德群.尺骨鷹嘴關節外截骨入路的解剖學研究及臨床意義[J].中國臨床解剖學雜志, 2009, 27(1):9-11.

1. Nauth A, Mckee MD, Ristevski B, et al. Distal humeral fractures in adults[J]. J Bone Joint Surg Am, 2011, 93A(7):686-700.
2. Gainor BJ, Moussa F, Schott T. Healing rate of transverse osteotomies of the olecranon used in reconstruction of distal humerus fractures[J]. J South Orthop Assoc, 1995, 4(4):263-268.
3. 王振威, 徐建高, 常林順.經尺骨鷹嘴關節外斜行截骨治療肱骨髁間骨折[J].中華創傷骨科雜志, 2006, 8(7):681-682.
4. 張喜海, 徐楊博, 卓乃強, 等.復雜肱骨遠端骨折內固定失敗相關因素分析及對策[J].中國骨與關節損傷雜志, 2010, 25(2):176-177.
5. Tian D, Jing J, Qian J, et al. Comparison of two different double-plate fixation methods with olecranon osteotomy for intercondylar fractures of the distal humeri of young adults[J]. Exp Ther Med, 2013, 6(1):147-151.
6. 王永才, 王紅川, 樓華, 等.經尺骨鷹嘴截骨雙側鎖定加壓鋼板內固定治療C型肱骨遠端骨折[J].中國修復重建外科雜志, 2013, 27(11):1404-1405.
7. 林紹儀, 劉金偉.經尺骨鷹嘴截骨入路雙側平行鋼板固定治療肱骨遠端關節內骨折[J].中國骨與關節損傷雜志, 2013, 28(1):86-87.
8. 顧海倫, 楊軍, 丁立峰, 等.尺骨鷹嘴截骨結合雙鋼板技術治療肱骨髁間粉碎性骨折[J].中華創傷雜志, 2013, 29(5):407-410.
9. 田大勝, 荊玨華, 周云, 等.尺骨鷹嘴截骨雙鋼板內固定治療青壯年C型肱骨髁間骨折[J].創傷外科雜志, 2013, 15(3):226-229.
10. Mckee MD, Kim J, Kebaish K, et al. Functional outcome after open supracondylar fractures of the humerus. The effect of the surgical approach[J]. J Bone Joint Surg Br, 2000, 82(5):646-651.
11. Gofton WT, Macdermid JC, Patterson SD, et al. Functional outcome of AO type C distal humeral fractures[J]. J Hand Surg Am, 2003, 28(2):294-308.
12. 吳英華, 張鐵良, 金碩, 等.經尺骨鷹嘴關節外斜行截骨治療肱骨髁間骨折[J].中華骨科雜志, 2005, 25(8):472-475.
13. 劉小坡, 劉德群, 劉會仁, 等.經尺骨鷹嘴入路關節外斜行截骨對血供影響解剖學觀察[J].中國臨床解剖學雜志, 2008, 26(4):363-365.
14. Schmidt-Horlohe K, Wilde P, Bonk A, et al. One-third tubular-hook-plate osteosynthesis for olecranon osteotomies in distal humerus type-C fractures:a preliminary report of results and complications[J]. Injury, 2012, 43(3):295-300.
15. 劉會仁, 劉小坡, 劉德群.尺骨鷹嘴關節外截骨入路的解剖學研究及臨床意義[J].中國臨床解剖學雜志, 2009, 27(1):9-11.

West China Medical Journal

Extra-articular and Intra-articular Olecranon Osteotomy in the Treatment of Patients with Intercondylar Fractures of the Distal Humerus

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