Zi-Zheng Wu,Jian-Dong Wang,Xiao-Xi Ji,Zhi-Jian Ma,Jian-Hong Wu,Qiu-Gen Wang.[J].中华创伤杂志英文版,2018,21(6):356-359
Surgical exposures of the distal humeral fractures: An anatomical study of theanterior, posterior, medial and lateral approaches
  
DOI:10.1016/j.cjtee.2018.07.006
KeyWord: ElbowExposuresDistal humerus fracturesSurgical approach
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Author NameAffiliation
Zi-Zheng Wu Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
Department of Orthopaedics, Baoshan Branch of Shanghai General Hospital of Shanghai Jiaotong University, Shanghai, China 
Jian-Dong Wang Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China 
Xiao-Xi Ji Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China 
Zhi-Jian Ma Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China 
Jian-Hong Wu Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China 
Qiu-Gen Wang Shanghai Trauma & Emergency Center, Shanghai General Hospital of Nanjing Medical University, Shanghai, China 
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Abstract:
      Purpose: Exposure of the articular surface is the key to the successful treatment of intra-articular fractures of distal humerus. Anterior, posterior olecranon osteotomy as well as medial and lateral approaches are the four main approaches to the elbow. The aim of this study was to compare the exposure of distal articular surfaces of these surgical approaches. Methods: Twelve cadavers were used in this study. Each approach was performed on six elbows according to previously published procedures. After completion of each approach, the exposed articular surfaces were marked by inserting 0.5 mm K-wires along the margins. The elbow was then disarticulated and the exposed articular surfaces were painted. The distal humeral articular surfaces were then closely wrapped using a piece of fibre-glass screen net with meshes. The exposed articular surfaces and the total articular surfaces were calculated by counting the number of meshes, respectively. Results: The average percentages of the exposed articular surfaces for the anterior, posterior olecranon osteotomy, medial and lateral approaches were 45.7% ± 2.0%, 53.9% ± 7.1%, 20.6% ± 4.9% and 28.5% ± 6.3%, respectively. Conclusion: The anterior and posterior approaches provide greater exposures of distal humeral articular surface than the medial and lateral ones in the treatment of distal humeral fractures.
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