Objective To evaluate the results of surgery on intercondylar of humerus. Methods Fifty-eight cases (26 males, 32 females), in an average age of 46. 6 (13 ~ 82 years), of intercondylar fracture of the humerus operated...Objective To evaluate the results of surgery on intercondylar of humerus. Methods Fifty-eight cases (26 males, 32 females), in an average age of 46. 6 (13 ~ 82 years), of intercondylar fracture of the humerus operated from September 1988 to September 1998 were followed up 29 months (8 ~ 63 months). According to the AO/MSIF classification 8, 7 and 5 cases were divided into type B1, B2 and B3 respectively while other 13, 10 and 15 patients into C1, C2 and C3 respectively. All the cases were evaluated by modified Jupiter assessment. Results Twenty-eight patients gained excellent results, while the good, fair and poor outcomes were found in twenty-two, three and five cases respectively. Conclusion Surgical treatment from posterior trans-olecranon approach with combination of internal fortion and bone graft, follwed by early active motion and adhesion relief procedure for elbow if necessary, was advocated in intercondylar fracture of humerus.展开更多
Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a...Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs.triceps-sparing approach for patients with distal humerus intercondylar fracture.Methods:The electronic searches were systematically performed in PubMed,EmBase,Cochrane library,and Chinese National Knowledge Infrastructure from initial inception till December 2019.The primary endpoint was the incidence of excellent/good elbow function,and the secondary endpoints included Mayo elbow performance score,duration of operation,blood loss,and complications.Results:Nine studies involving a total of 637 patients were selected for meta-analysis.There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function(odds ratio[OR]:1.37;95%confidence interval[CI]:0.69-2.75;P=0.371),Mayo elbow performance score(weight mean difference[WMD]:0.17;95%CI:-2.56 to 2.89;P=0.904),duration of operation(WMD:4.04;95%CI:-28.60 to 36.69;P=0.808),blood loss(WMD:33.61;95%CI:-18.35 to 85.58;P=0.205),and complications(OR:1.93;95%CI:0.49-7.60;P=0.349).Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function,longer duration of operation,greater blood loss,and higher incidence of complications as compared with triceps-sparing approach.Conclusions:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function,while the duration of operation,blood loss,and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.展开更多
文摘Objective To evaluate the results of surgery on intercondylar of humerus. Methods Fifty-eight cases (26 males, 32 females), in an average age of 46. 6 (13 ~ 82 years), of intercondylar fracture of the humerus operated from September 1988 to September 1998 were followed up 29 months (8 ~ 63 months). According to the AO/MSIF classification 8, 7 and 5 cases were divided into type B1, B2 and B3 respectively while other 13, 10 and 15 patients into C1, C2 and C3 respectively. All the cases were evaluated by modified Jupiter assessment. Results Twenty-eight patients gained excellent results, while the good, fair and poor outcomes were found in twenty-two, three and five cases respectively. Conclusion Surgical treatment from posterior trans-olecranon approach with combination of internal fortion and bone graft, follwed by early active motion and adhesion relief procedure for elbow if necessary, was advocated in intercondylar fracture of humerus.
基金This study was supported by the grants from the Beiing Municipal Health Commission(No.BMHC2019-9)Beiing Natural Science Foundation(No.L192049)Beiing Jishuitan Hospital's“Discipline new star”Plan(No.XKXX201604)。
文摘Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs.triceps-sparing approach for patients with distal humerus intercondylar fracture.Methods:The electronic searches were systematically performed in PubMed,EmBase,Cochrane library,and Chinese National Knowledge Infrastructure from initial inception till December 2019.The primary endpoint was the incidence of excellent/good elbow function,and the secondary endpoints included Mayo elbow performance score,duration of operation,blood loss,and complications.Results:Nine studies involving a total of 637 patients were selected for meta-analysis.There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function(odds ratio[OR]:1.37;95%confidence interval[CI]:0.69-2.75;P=0.371),Mayo elbow performance score(weight mean difference[WMD]:0.17;95%CI:-2.56 to 2.89;P=0.904),duration of operation(WMD:4.04;95%CI:-28.60 to 36.69;P=0.808),blood loss(WMD:33.61;95%CI:-18.35 to 85.58;P=0.205),and complications(OR:1.93;95%CI:0.49-7.60;P=0.349).Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function,longer duration of operation,greater blood loss,and higher incidence of complications as compared with triceps-sparing approach.Conclusions:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function,while the duration of operation,blood loss,and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
