The comparison of triceps-reflecting anconeus pedicle and olecranon osteotomy approaches in the treatment of intercondylar fractures of the humerus

BACKGROUND: This study aimed to evaluate the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy. METHODS: Forty patients with intra-articular distal humerus fractures were retrospectively analyzed. TRAP approach was used in 22 patients (12 males, 10 females; mean age 37.8 years, range 17-70), and olecranon osteotomy in 18 patients (11 males, 7 females; mean age 35.4 years, range 18-62). Fractures were classified using the AO/ASIF classification. Functional results were evaluated with the Mayo elbow performance score (MEPS) and the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score. RESULTS: The overall mean arc of elbow motion was 108 degrees (range 70 degrees-140 degrees) in the TRAP group, whereas that of the olecranon osteotomy group was 98 degrees (range 70 degrees-115 degrees). A significant difference was observed between the two groups in terms of overall mean arc of elbow motion (p=0.038). There were no significant differences noted between the two groups in terms of mean MEPS and DASH scores (p=0.412, p=201, respectively). The overall complication rate was 27.2% in the TRAP group and 55% in the olecranon osteotomy group. CONCLUSION: TRAP is a succesful approach in the treatmet of intra-articular distal humerus fractures that provides better arc of elbow motion, reduces complications and reoperation rates.