A study of functional outcomes of distal humerus fractures operated by triceps reflecting approach

Introduction: Approaches to distal humerus has been a great controversy of which cheverons osteotomy is considered a gold standard. However it is associated with implant and procedure related complication, Hence we studied a triceps reflecting (Bryan –Morrey) approach with some modification so as to achieve good exposure to distal humerus with intact olecranon. Methods: In our study we retrospectively studied 13 skeletally mature distal humerus fractures at our center treated by TRA with minimum follow up for a period of 3 months. They were functionally assessed with DASH Score, MAYO score, triceps power evaluation with MRC grading, measurements of ROM and Radiological union. Results: Mean duration of follow up was Ten months in 13 patients, with an average age of 43.23 years. The mean Quick DASH score was 3.85, mean Mayo score was 89 indicating an good performance, mean Triceps muscle power MRC grading 5 with adequate mean functional ROM 23-114 degree(extension –flexion). Only 2 patients had complication of which one was screw breakage and other was wound dehiscence which was not related to approach. Conclusion: TRA is a better option as it avoids creating a new fracture and preserving the joint anatomy as compared to olecranon osteotomy with adequate exposure of the joint to carry out the fixation. As from our series functional outcomes of strength of triceps is comparable with that of the other side