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

Introduction: Intercondylar fractures owing to complex anatomy of elbow joint and neurovascular structures in surrounding makes it difficult to treat. Operative techniques like open reduction and internal fixation helps in achieving desired anatomy and improves patient compliance. This study is aimed at comparing outcome of patient treated with triceps reflecting anconeus pedicle(TRAP) approach and olecranon osteotomy. Objective: Comparison among exposure modalities of Open reduction internal fixation by triceps reflecting anconeus pedicle approach and olecranon osteotomy. Materials and Method: This is a retrospective study of 50 patients with supracondylar fracture humerus treated by open reduction and internal fixation in Civil Hospital, Ahmedabad from April 2016 to March 2017. TRAP approach was used in 28 patients (16 males, 12 females) and olecranon osteotomy was used in 22 patients (12 males, 10 females). DASH(Disabilities of Arm, Shoulder and Hand) and MEPS(Mayo Elbow Performance Score) were used as tools for assessment. Result: Range of movement of elbow is 85-135 in TRAP group whereas in olecranon osteotomy group it is 65- 110 (p=. This difference is significant (p= 0.038). In terms of mean MEPS and DASH score difference is not significant. Complication rate was 32.14% in TRAP group whereas it was 55% in olecranon osteotomy group. Conclusion: Thus ORIF with exposure techniques involving triceps reflecting anconeus pedicle is better approach in terms of lower complication rate and higher range of movements.