Olecranon osteotomy vs. triceps-sparing for open reduction and internal fixation in treatment of distal humerus intercondylar fracture: a systematic review and meta-analysis.
10.1097/CM9.0000000000001393
- Author:
Shuai LU
1
;
Ye-Jun ZHA
;
Mao-Qi GONG
;
Chen CHEN
;
Wei-Tong SUN
;
Ke-Han HUA
;
Xie-Yuan JIANG
Author Information
1. Department of Orthopedic Trauma, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan Hospital, Beijing 100035, China.
- Publication Type:Systematic Review
- MeSH:
Elbow Joint/surgery*;
Fracture Fixation, Internal;
Humans;
Humeral Fractures/surgery*;
Humerus;
Olecranon Process/surgery*;
Osteotomy;
Range of Motion, Articular;
Treatment Outcome
- From:
Chinese Medical Journal
2021;134(4):390-397
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.
METHODS:The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.
RESULTS:Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI: -2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.
CONCLUSIONS:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
