Unlabelled: This paper describes a modification of the traditional fascial tongue surgical approach to the distal humerus. In particular, we describe the reflection and utilisation of radial and ulnar triceps bundles to allow complete visualisation of the distal humerus. This extensile technique allows access to the entirety of the distal humerus and provides excellent visualisation to the operating surgeon. Indications for the surgical approach include open reduction with internal fixation of fractures (both intra- and extra-articular) and total elbow replacement. Whilst standard approaches to the distal humerus are well described, this modification describes a new surgical approach that improves access and visualisation of the traditional fascial tongue technique. Alternative approaches to improve visualisation include an olecranon osteotomy; the triceps bundle modification allows excellent exposure to the distal humerus whilst avoiding complications associated with an olecranon osteotomy. The surgical technique is illustrated with intra-operative photographs, which aim to aid in guiding the surgeon in undertaking critical steps of this approach.
How To Cite This Article: Rankin IA, Dixon J, Goffin J, A Modified Surgical Approach to the Distal Humerus: The Triceps Bundle Technique. Strategies Trauma Limb Reconstr 2024;19(2):99-103.
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http://dx.doi.org/10.5005/jp-journals-10080-1618 | DOI Listing |
Curr Rev Musculoskelet Med
January 2025
, San Francisco, USA.
Purpose Of Review: This review aims to provide a comprehensive analysis of the nonoperative management of Gartland Type II fractures in pediatric patients.
Recent Findings: Supracondylar humeral fractures (SCF) are one of the most common traumatic fractures in pediatric populations, characterized as transverse fractures at the distal humerus between the medial and lateral columns. Early studies strongly opposed closed reduction and casting as an acceptable treatment modality for Gartland type II fractures as an early case series showed high rates of complications; however, more recent studies have suggested better outcomes.
JBJS Essent Surg Tech
January 2025
Shoulder and Elbow Service, Florida Orthopaedic Institute, Tampa, Florida.
Background: The incidence of revision shoulder arthroplasty continues to rise, and infection is a common indication for revision surgery. Treatment of periprosthetic joint infection (PJI) in the shoulder remains a controversial topic, with the literature reporting varying methodologies, including the use of debridement and implant retention, single-stage and 2-stage surgeries, antibiotic spacers, and resection arthroplasty. Single-stage revision has been shown to have a low rate of recurrent infection, making it more favorable because it precludes the morbidity of a 2-stage operation.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Department of Psychiatry, College of Medicine and Health Sciences, Arabian Gulf University, Manama 329, Bahrain.
Background: Osteoporosis-related fragility fractures are increasing worldwide. An assessment of the prevalence of fragility fractures in Bahrain is needed to determine proper action and preventive strategies. The main objective of this study was to conduct a retrospective cross-sectional study to investigate the prevalence of fragility fractures in adult Bahraini patients.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
Pediatric Orthopedic Hospital, Honghui Hospital, Xi'an Jiao tong University, Xi'an, 710000, China.
Background: Supracondylar humerus fractures (SCHFs) are the most common elbow fractures in children and are typically treated with closed reduction and Kirschner pin fixation. However, varying degrees of residual rotational displacement may remain after closed reduction. Several methods exist to assess rotational displacement, but none account for the effect of elbow rotation on the results.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Background: Finite element analysis (FEA) could advance the understanding of fracture fixation and guide the choice of surgical treatment. This study aimed to compare two internal fixation methods in the treatment of displaced proximal humeral fracture (PHF) through FEA.
Methods: Three-dimensional FEA model based on the left shoulder joint of a 67-year-old female patient with PHFs and osteoporosis was adopted, in order to analyze the fixation effect and load stress distribution of internal fixation plates with open reduction and intramedullary nails without opening the fracture in the treatment of Neer III-VI PHF.
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