Short-Term Results After Intra-Articular Fractures of the Distal Humerus Treated by a Paratriceps Approach

Introduction: Operative treatment of displaced intra-articular distal humerus fractures is still the gold standard in the management of these challenging injuries. Triceps damaging approaches, as well as bulky or numerous implants, are often associated with complications leading to the development of moderate to severe elbow stiffness. The shortened pre-operation time, the use of approaches preserving the integrity of m. triceps brachii, and the use of optimal osteosynthesis implants to achieve maximum stability with minimal soft tissue damage suggests early elbow mobilization and prevention of stiffness and contracture. Materials and Methods: Eleven patients after surgical treatment for intra-articular distal humerus fractures (AO type 13C and 13B) were included in the study. A posterior paratriceps approach was used. Soft immobilization was applied postoperatively. Patients were followed up in the postoperative period on the 14th, 30th, and 45th day. Rehabilitation and physical therapy courses were conducted, function was assessed, and a questionnaire, the Mayo Elbow Performance Score (MEPS), was filled out. Results: The results achieved in the flexion-extension arch were as follows: 14th day—24° ± 4.5°, 30th day—50°±5.5°, and 45 day—110.5°±8°. Pronosupination for the same periods was 75° ± 8°, 133°±6°, and 156° ± 4°, and MEPS—34±7p, 62±9p, and 90±5p. Conclusion: Surgical reconstruction of intra-articular fractures of the distal humerus through the Alonso-Llames paratriceps approach with stable fracture fixation allowed for early physical therapy and rehabilitation, which is a prerequisite for excellent functional result.