Management of Extra-Articular Distal Humerus Fractures Using Triceps Splitting Versus Triceps Sparing

Abstract

Background: Treatment of extra articulardistal humeus fractures seen in traumatic population is to
prevent the probable complications as joint stiffness, limitation of movement and joint deformity, by
providing good fixation and early mobilization. The aim of the present study was to find the Better
management and improving outcome of patients with extra-articular distal humerus fractures. Patients
and methods: In this study included 24 patients were divided into two groups, 12 patients for Triceps
sparing technique and 12 patients for triceps splitting technique. The mean duration of follow up was
7.4 ±3.4 months. A treatment protocol was designd for all patient by preoperative evaluation,
intraoperative evaluation and post operative evaluationusing radiological assessment and clinical
finding by MEPI and DASH score. Results: The mean age was 42.9 ± 9 in triceps splitting group and
was 43.6 ± 9.7 in triceps sparing group. There was no statistically significant difference between two
groups as regard intra-operative blood loss. The mean MEPI was 94.2 ± 4.7 with four excellent, five
good, and three fair grades. The mean DASH score was 18.3 ± 3.3 points. The mean range of elbow
flexion was143.3 ± 3.9. The mean range of elbow extention and contracture 8.6 ± 1.7 in group II.
Conclusion: Triceps-splitting approach was found to afford adequate exposure of even the most
complex fractures, and to allow for proximal extension when the fracture had proximal extension.But
this approachinvolves splitting of the muscle and thus denervating a portion of the muscle and
disruption of the extensor mechanism requiring postoperative protection and the risk of triceps
dehiscence.