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Paratricipital Approach for AO/OTA Type C2 Intra-Articular Fracture of Distal Humerus
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Chul Hyung Lee, Doo Hun Sun, Deukhee Jung, Chung Han An
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J Korean Fract Soc 2019;32(3):128-134. Published online July 31, 2019
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DOI: https://doi.org/10.12671/jkfs.2019.32.3.128
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Abstract
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The aim of this study was to determine the outcomes of fixation of AO/OTA type C2 fractures among intra-articular fractures of the distal humerus using the paratricipital approach (side to side retraction of the triceps). MATERIALS AND METHODS From June 2008 to January 2018, 12 patients underwent an open reduction and internal fixation with the paratricipital approach and were followed-up for more than 10 months after surgery. According to the AO/OTA classification, type C2 fractures were chosen among the intraarticular distal humerus fractures. An extended posterior incision was used over the olecranon in the prone position, preserving the insertion site of the triceps brachii muscle. The fracture site was exposed by retracting the muscle side-to side through a dissection of the medial and lateral intermuscular septum of the triceps brachii muscle. The therapeutic results were assessed by the anatomical reduction of the articular surface and integrity of the metaphyseal contour in postoperative simple radiographs, complications, such as neuropathy or non-union, and the Mayo elbow performance score (MEPS) were checked to estimate the functional outcome. RESULTS In the postoperative simple radiographs, no case showed more than 1 mm step-off and the disrupted contour of the distal humerus was recovered to normal alignment in most cases. The range of elbow joint motion in the last follow-up was 133.8° on average with a mean flexion contracture of 5.0°. The clinical results depending on the MEPS were excellent, except for two cases, which were good. Neuropathy of the ulnar nerve was observed in one patient, which was resolved after metal removal. CONCLUSION The paratricipital approach is useful technique in AO/OTA type C2 intra-articular distal humerus fractures that provides sufficient exposure of the surgical field, without injury to the triceps brachii muscle and postoperative complications associated with the trans-olecranon approach.
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- Short-Term Results After Intra-Articular Fractures of the Distal Humerus Treated by a Paratriceps Approach
Petar Petkov Scripta Scientifica Medica.2025; 57(1): 48. CrossRef
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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia
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Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon
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J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.2.291
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Abstract
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To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia.
MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria. RESULTS According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria. CONCLUSION For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.
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Comparison of radial head excision and open reduction & internal fixation for comminuted radial head & neck fracture
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Jae Gune Jun, Chul Hyung Lee, Sung Jun Han, Sang Seon Lee, Won Tae Choi, Ho Rim Choi, Jeong Woung Lee
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J Korean Soc Fract 2001;14(1):106-112. Published online January 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.1.106
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The goals of the present study were to compare of radial head excision and open reduction k internal fixation for comminuted radial head & neck fracture. MATERIALS AND METHODS From march 1993 to February 1999, Patients with fracture of radial head (Mason type III) who were treated at Dae-Jeon Sun General hospital were enrolled in the study. The average duration of follow up was 3 years and 3 months. Six patients(Group A) were treated with radial head excision and fourteen patients(Group B) were treated with open reduction and internal fixation. RESULTS By functional rating index(modified After B.F. Morrey et al), in Group A, the results were classified as excellent(1 patient), good(No patient), fair(2 patients), and poor(3 patients), and in Group B, excellent(4 patients), good(5 patients), fair(3 patients), and poor(2 patients). CONCLUSION We concluded clinically to obtain better outcome in group which were treated with open reduction and internal fixation than radial head excision. Therefore, though the treatment of choice for Mason type III radial head fracture was total excision, in consideration of complication, procedure to preserve radial head was desirable. We must give careful consideration to possibility of open reduction and decision of radial head excision.
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