Background

In distal humerus fracture surgery, postoperative ulnar neuropathy is a common complication. The present study assessed the utility of the modified paratricipital approach for preventing ulnar neuropathy. This approach preserved the continuity of the attachment of the triceps with the ulnar nerve and allowed anterior subluxation of the ulnar nerve onto the hardware to be avoided.

Methods

From December 2018 to March 2020, 13 patients who underwent surgery for distal humerus fracture through the modified paratricipital approach at our hospital were prospectively enrolled in the study. Ulnar neuropathy, Mayo Elbow Performance Score (MEPS), and Range of motion (ROM) were evaluated.

Results

No postoperative ulnar neuropathy was observed. At the final follow-up, the mean Mayo Elbow Performance score was 97.7 (range, 85–100). The mean arc motion was 132.7° (range, 115°–145°) with a mean flexion contracture of 4.2° (range, 0°–10°) and mean flexion of 136.2° (range, 120°–145°). Hardware breakage leading to a loss of reduction occurred in one case, but the other fractures united.

Conclusions

Our results demonstrated the effectiveness of the modified paratricipital approach for preventing postoperative ulnar neuropathy. The modified paratricipital approach is a safe and reliable method of performing distal humerus fracture surgery.

中文翻译：

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无需动员尺神经的改良旁头入路可预防肱骨远端骨折术后尺神经病变

背景

在肱骨远端骨折手术中，术后尺神经病变是常见的并发症。本研究评估了改良旁头入路在预防尺神经病变方面的效用。这种方法保留了三头肌与尺神经附着的连续性，并避免了尺神经在硬件上的前半脱位。

方法

前瞻性纳入2018年12月至2020年3月期间在我院接受改良旁肱骨入路手术治疗肱骨远端骨折的13例患者。评估了尺神经病变、梅奥肘部性能评分 (MEPS) 和运动范围 (ROM)。

结果

术后未观察到尺神经病变。在最后一次随访中，梅奥肘部性能平均得分为 97.7（范围：85-100）。平均弧度运动为132.7°（范围，115°–145°），平均屈曲挛缩为4.2°（范围，0°–10°），平均屈曲为136.2°（范围，120°–145°）。其中一例发生硬件断裂导致复位丢失，但其他骨折合并在一起。

结论

我们的结果证明了改良旁头入路对于预防术后尺神经病变的有效性。改良旁肱骨入路是一种安全可靠的肱骨远端骨折手术方法。