The triceps reflecting approach (Bryan-Morrey) for distal humerus fracture osteosynthesis.
The triceps reflecting approach (Bryan-Morrey) for distal humerus fracture osteosynthesis.
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DOI：
10.1186/1471-2474-15-406
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发表时间：
2014-12-04
影响因子：
2.3
通讯作者：
Rikli D
中科院分区：
文献类型：
--
作者：
Iselin LD;Mett T;Babst R;Jakob M;Rikli D
“Chevron”-鹰嘴截骨术通常用于肱骨远端关节内骨折的入路，但通常与手术相关并发症有关。我们研究了保留伸肌装置的肱三头肌反射入路（TRA），作为一种安全的替代方法，可充分暴露手肘关节，并有助于以完整的鹰嘴为模板实现解剖骨折复位。我们在两个创伤中心进行了一项回顾性研究，确定了31例经TRA治疗的肱骨远端骨折。24例患者返回随访，包括病史记录、体格检查、手术部位与正常部位的功能分析（DASH和马约评分）、活动度测量、等长肘力量测量和影像学记录。24例患者（13例女性，11例男性）的平均FU持续时间为51个月（24个月-12年），平均年龄为57.7岁（范围17-89岁）。AO分类显示5例A2、1例B2、2例C1、9例C2和7例C3骨折。影像学检查显示所有患者均能充分复位、肱骨远端对线和骨折愈合。屈曲和伸展的强度分析显示，末次随访时强度无统计学相关损失。活动范围很好。TRA是ORIF治疗肱骨远端关节内骨折的一种有价值的选择。它保留了鹰嘴的正常关节解剖结构，避免了与鹰嘴截骨术相关的潜在并发症。我们系列的临床结果参数显示，与对侧相比，强度保持良好。
“Chevron”-Olecranon osteotomies are commonly used for the approach to intraarticular distal humerus fractures but are often associated with procedure related complications. We studied the triceps reflecting approach (TRA) with preservation of the extensor apparatus as a safe alternative giving a sufficient exposure to the elbow joint and helping to achieve anatomical fracture reduction with the intact olecranon as a template. We performed a retrospective review at two trauma centres and identified 31 skeletally mature distal humerus fractures treated with a TRA. 24 of the patients returned to follow-up including history recording, physical examination with functional analysis of the operated vs the normal site with the DASH and Mayo scores, measurement of range of motion, isometric elbow strength measurement and radiographic documentation. Mean duration of FU was 51 months (24 months-12 years) in 24 patients, 13 female, 11 male with an average age of 57.7 years (range 17-89). AO Classification showed five A2, one B2, two C1, 9 C2 and 7 C3 fractures. Radiologic control showed adequate reduction, distal humeral alignment and fracture healing in all patients. The strength analysis of flexion and extension revealed no statistically relevant loss of strength at last FU. Range of motion was excellent. The TRA is a valuable option for ORIF in distal intraarticular humerus fractures. It preserves the normal joint anatomy of the olecranon and avoids the potential complications associated with olecranon osteotomy. The clinical outcome parameters of our series revealed excellent maintenance of strength compared to the contralateral side.
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DOI：
10.2106/00004623-200012000-00003
发表时间：
2000-12-01
影响因子：
5.3
作者：
McKee, MD;Wilson, TL;Richards, RR
通讯作者：
Richards, RR
影响因子：
1.8
作者：
O'Driscoll, SW
通讯作者：
O'Driscoll, SW
影响因子：
2.3
作者：
Ring, D;Gulotta, L;Jupiter, JB
通讯作者：
Jupiter, JB
影响因子：
3
作者：
Wilkinson, JM;Stanley, D
通讯作者：
Stanley, D
影响因子：
1.8
作者：
DeSimone, Lori J.;Sanchez-Sotelo, Joaquin
通讯作者：
Sanchez-Sotelo, Joaquin