Osteosynthesis of Distal Humeral Metaepiphyseal Fractures Via Posterior Approach with Olecranon Preservation

Eighteen patients with distal humeral metaepiphyseal fractures were operated on during the period from 2010 to 2013. Mean age of patients made up 43.1±8.4 (22-72) years, term after injury - 4.6±1.9 (2-11) days. According to AO classification C1 fractures were diagnosed in 13, C2 - in 3, C3 - in 2 patients. In all patients distal humeral metaepiphyseal osteosynthesis with two plates placed at 90° to each other was performed. Surgical intervention was performed without olecranon osteotomy and triceps tendon was kept intact. In 12 (66.7%) cases longitudinal dissection of the triceps in its middle third was performed. Residual intraarticular displacement averaged 0.2±0.03 mm. Long term results were assessed in 10 patients at an average 12 months after operation. Mean score by subjective and objective scales made up 4.3±0.3 and 4.2±0.3 points, respectively. Main advantages of the applied osteosynthesis technique were preservation of forearm extensor muscles integrity; absence of additional fixatives in olecranon zone; absence of the necessity to perform additional intervention to remove fixatives from the olecranon.