Analysis Of Curative Effect After Different Kinds Ofoperationapproach In The Treatment Of Type C Distal Humeral Fracture In Young Adults

Objective:To study the clinical effects of triceps-snip and olecranon osteotomy approach for treatment of young adult type C distal humeral fracture.Methods:A retrospective analysis from September 2010 to March 2014 inthe six affiliated hospital of Xinjiang MedicalUniversity was reviewed.Treating with triceps-snip approach or olecranon osteotomy approach reconstruction plate double column fixated distal humeral fractures in young adult patients. Comparison of two groups:(1) operation time, (2) fracture healing time, malunion, nonunion, heterotopic ossification and other complications, (3) elbow motion, (4) the Mayo elbow performance score(MEPS), (5) the triceps muscle strength. Postoperative functional exercise was done.Results:The median follow-up time was12.7(range,6～24) months. Operation time and the healing time was similar between the two groups and had no statistical significance.Triceps-snipgrouppatient’saverage MEPS was74.93±9.12, significantly lower than the approach of olecranon osteotomy group patient’s83.15±8.52.The two groups had statistically significant (P<0.05).Triceps-snip groups patient’s elbow motion was 77.00± 11.93, significantly lower than the approach of olecranon osteotomy group patient’s96.11 ±10.32, the difference was statistically significant (P<0.05).The two groups the incidence of postoperative complications compared had no significant difference.To compare the triceps muscle, there was no significant difference between the two groups. There was no nonunion, internal fixation failure and loosening, no elbow stiffness occurred. According to AO classification, the olecranon osteotomy approach gets a better function than triceps-snip approach with type C2 and C3 fracture. But comparing two groups with type C1 had no significant difference.Conclusions:The approach of olecranon osteotomy could do early function exercise. With correct function exercise instruction, complications are not significantly increased. These efforts are more conducive to the recovery of elbow joint function.