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Background: Distal humerus fractures are common and can be difficult to treat. No one approach to the distal humerus has been shown to be superior to another; however, the olecranon osteotomy remains the gold standard for complex, intra-articular fractures. Understanding the percent of articular exposure with approaches to the distal humerus is important for success. The goal of this study is to show the percent of articular exposure of the triceps fascial tongue approach as compared with the olecranon osteotomy.
Methods: Twelve fresh frozen cadavers were separated randomly into 2 groups of 6 each. The first group of 6 specimens was allocated to the triceps fascial tongue approaches with the collaterals maintained and with the collaterals released off the ulna and elbow dislocated. The second group of 6 was allocated to the triceps fascial tongue approach while maintaining the collaterals followed by an olecranon osteotomy. The articular exposure was marked after performing each approach, and the percent of articular exposure was quantified by using 3D scanning. Standard deviations were calculated for each.
Results: The average percent visualization of the distal humerus articular surface in the fascial tongue approach while maintaining the collaterals was 36% in the first cohort and 37% in the second cohort with a standard deviation of 5% in both cohorts. The average percent of the distal humerus articular surface exposed in the fascial tongue approach with the collaterals released off the ulna and elbow dislocated was 85.09% with a standard deviation of 4%. The average percent of the distal humerus articular surface exposed in the olecranon osteotomy group was 57.9% with a standard deviation of 5%.
Conclusion: The triceps fascial tongue approach allows for visualization of about one-third of the joint, which may be adequate for many intra-articular distal humerus fractures. For added exposure of the articular surface, the collaterals may be elevated from the ulna and the elbow dislocated allowing for a substantial increase in percent of articular exposure compared with the collateral retaining fascial tongue approach and the olecranon osteotomy.
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http://dx.doi.org/10.1016/j.jse.2022.08.025 | DOI Listing |
Einstein (Sao Paulo)
December 2024
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Epiphyseal displacement of the distal humerus is rare and difficult to diagnose. In addition, the literature on the prognosis and treatment is limited. Here, we present a case of distal humeral physeal separation with significant displacement in a neonate.
View Article and Find Full Text PDFTrauma Case Rep
December 2024
Yale University, Department of Orthopaedics and Rehabilitation, New Haven, CT 06510, United States of America.
A 13-year-old male presented with an open left humeral shaft fracture with intramuscular distal biceps rupture after being struck by a car. He underwent washout, humerus fixation, and open biceps repair. Immediate postoperative course was complicated by deep infection and failure of biceps repair.
View Article and Find Full Text PDFBone
December 2024
Bone and Joint Center, Henry Ford Health, Detroit, MI, USA; Henry Ford Health + Michigan State University Health Sciences, Detroit, MI, USA. Electronic address:
Bone fractures due to osteoporosis are a significant problem. Limited accuracy of standard bone mineral density (BMD) for fracture risk assessment, combined with low adherence to bone health screening precludes identification of those at risk of fracture. Because of the wide availability of digital breast tomosynthesis (DBT) imaging, bone screening using a DBT scanner at the time of breast screening has been proposed.
View Article and Find Full Text PDFJ Orthop Case Rep
December 2024
Department of Orthopaedics, Institute of Orthopaedics and Sports Medicine, St. Luke's Medical Center, Quezon, Philippines.
Introduction: Aneurysmal bone cysts (ABCs) are benign, locally destructive, blood-filled reactive lesions of the bone most commonly presenting as pain or mass effect. Most are frequently located in the proximal humerus, distal femur, proximal tibia, spine, uncommonly the sacrum, and rarely the sacroiliac (SI) joint. We present a rare case of ABC in the SI joint and its recurrence treated with percutaneous intralesional doxycycline ablation and the corresponding outcome.
View Article and Find Full Text PDFJ Child Orthop
December 2024
Department of Pediatric Orthopaedic Surgery, Robert Debré University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), France.
Background: The newborn transphyseal fracture of the distal humerus is frequently misdiagnosed with an elbow dislocation due to the absence of the lateral condyle ossification node. No consensus has been reported either for the diagnosis or the management of these rare fractures. This study aimed to analyze a series of newborns with transphyseal distal humerus fractures.
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