DEPARTMENT OF ORTHOPAEDICS

ALLURI SITARAMA RAJU ACADEMY

OF MEDICAL SCIENCES
 “ A STUDY OF SURIGICAL
MANAGEMENT OF INTRA
ARTICULAR FRACTURES OF DISTAL
HUMERUS IN ADULTS WITH
TRICEPS SPLITTING APPROACH
WITHOUT OLECRONON
OSTEOTOMY”

DR.NEELIMA MAJJI
1 ST YEAR PG
ORTHOPAEDICS
SYNOPSIS OF DISSERTATION TOPIC

• NAME : Dr. NEELIMA MAJJI

• COURSE : MS ORTHOPAEDICS
• GUIDE : Dr. R M MALLIKARJUNA REDDY
 INTRODUCTION
• Distal humerus fractures are unusual injuries
that estimated less than 2% of among all adult
fractures.

• The treatment of distal humerus fractures are

difficult due to complex shape of elbow joint.
• Open reduction and internal fixation
treatment achieved acceptable results in a
majority of patients.

• Restoration of painless and satisfactory elbow

function after a fracture of distal humerus
need anatomic reconstruction of the articular
surface.
• In triceps splitting approach without
olecranon osteotomy, olecranon acts as a
buttress and helps in indirect reduction of
the fracture with less trauma ,early
mobilization ,less neurovascular
complications
• This procedure also avoids complications
due to olecranon osteotomy like
nonunion.
AIMS AND OBJECTIVES
• AIM: To treat distal humerus fractures with
intraarticular extension in adults with open
reduction and internal fixation using triceps
splitting approach without olecronon
osteotomy.
• OBJECTIVE: To study the functional outcome of
surgical management of intraarticular
extension of distal humerus fractures using
triceps splitting approach without olecranon
osteotomy in terms of reduction of fracture,
and function of elbow.
• To study the advantages and complications of
the procedure
PATIENTS AND METHODS
• PLACE OF STUDY: DEPT.OF ORTHOPAEDICS,
ASRAM
• STUDY PERIOD: August 2019 to Sep 2021

• STUDY SIZE : 30

• TYPE OF STUDY: A randomised prospective study

INCLUSION CRITERIA
• Patients with intercondylar fracture of the distal end of
the humerus.

• Patients above the age of 18 years.

• Patients medically fit for surgery.

EXCLUSION CRITERIA
• Compound fractures of the distal humerus.

• Old fractures of the distal humerus.

• Patients not willing for surgery.

• Patients medically unfit for surgery.

METHODOLOGY
• SOURCE OF DATA

• Adult Patients having Distal humerus fractures

involving articular surface who are admitted to
ASRAM Hospital attached to ASRAM Medical College
will be taken up for study after obtaining their
informed written consent. This is a prospective study
from August 2019 to Sept 2021.
METHODOLOGY
• COLLECTION OF DATA

• Collection of data of patients presenting with

fracture of Distal humerus are as follows:-
• History by Verbal communication
• Clinical examination, both local and systemic.

CONTINUED..
 METHODOLOGY
COLLECTION OF DATA
• Baseline investigation and others.
• Fracture anatomy assessed with X-rays.
• Diagnosis – Clinical and Radiological.
• Informed written consent will be taken for Surgical
procedure.
• Surgery – Open reduction and Internal fixation with
triceps splitting approach without olecranon
osteotomy.
FOLLOW UP
• Regular follow up at 6 weeks,3 months,6 months and 1 year with x ray
(ap and lateral view).

• At every follow up assess for any radiological union or non union and
also assess for any complications like ulnar nerve neuropathy, infection,
non union, malunion ,avascular necrosis

• Functional assessment is done with the help of

A.Riseborough and Radin method
• B. Jupiter’s Modification of Cassebaum’s Grading System
• C. Mayo Elbow Performance Index
Excellent > 90
Good - 75-89
Fair - 60-74
Poor- <60
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THANK YOU