Surgical Treatment Of Distal Humeral Coronal Plane Fractures Through Combined Anterior- Lateral Approach And Kocher Approach

Objective:To explore surgical procedure of combined anterior-lateral approach and Kocher approach for the treatment of distal humeral coronal plane fractures.Methods:From March 2008 to February 2014,14 patients with closed coronal plane fractures of the distal humerus were surgically treated by open reduction and internal fixation with Bold screws through combined anterior-lateral approach and Kocher approach. All the fractures were classified into type 2A (7 cases), type 2B(1 case), type 3A(4 cases) and type 3B(2 cases) according to Dubberley classification.Results:12 cases were followed up for an average period of 14.2 months (ranged,10 to 22 months),and follow-up was lost in 2 patients. All fractures obtained bone healing from 10 to 16 weeks. The average Mayo Elbow Score Performance Index was 87.5. The complications were degenerative arthritis in 1 (8%), heterotopic ossification in 3 (25%). There was no infection, neural or vascular injury. The mean elbow range of motion ranged from 8°(0°～22°) to 122°(95°～135°).Conclusion:Through combined anterior-lateral approach and Kocher approach, treatment of distal humeral coronal plane fractures with Bold screws was characterized by anatomic reduction, reliable fixation and early rehabilitation.