Distal humerus dual plating with triceps tongue technique: A case series

Abstract

Background: Fixation of intra-articular distal humerus fractures has remained a challenge to orthopaedic surgeons due to complicated anatomy of elbow, comminution at fracture site and osteopenia of articular surfaces. We aimed to evaluate the functional outcomes and complications after dual plating for distal humerus fractures with triceps tongue technique. Material and methods: We conducted a retrospective study which consisted of 20 cases of distal humerus fracture with intraarticular extension and treated with open reduction and internal fixation with dual column plating using triceps tongue technique. Triceps Tongue approach allows exposure of distal humerus articular surface by forming an inverted V-shaped flap of distal triceps at the musculotendinous junction. Results: Union was achieved in all cases. Mean time of fracture union was 12.55±1.82 weeks. There was no case of non-union although elbow stiffness occurred in one patient. The mean MEPS score was 84.45±8.18 with a range of 70-96. Conclusion: Triceps Tongue approach is a simple and less technically demanding approach for the surgeon that can be used in management of the majority of the distal humeral fractures, giving adequate exposure of the surgical field, aiding in proper reduction of fracture fragments and thus obviating the need for an olecranon osteotomy.