Surgical approach for fracture of distal humerus: Posterior vs lateral

  • Michela Saracco Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Alessandro Smimmo Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Davide De Marco Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Osvaldo Palmacci Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Giuseppe Malerba Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Raffaele Vitiello Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Giulio Maccauro Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Felice Minutillo | feliceminutillo@libero.it Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Giuseppe Rovere Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.

Abstract

Humeral fractures have an incidence of 3-5% and a bimodal age distribution. They may occur in young patients after highenergy traumas or in elderly osteoporotic patients after low-energy injuries. In nondisplaced fractures or in elderly patients, humeral fractures are treated by conservative methods. Open reduction and internal fixation (ORIF) should be the treatment of choice in case of multi-fragmentary fractures associated with radial nerve palsy or not. ORIF is usually regarded as the gold standard treatment, but, depending on the different types of fracture, the surgical approach can change. In this review, we compare results and complication rates between lateral and posterior surgical approaches in the management of extraarticular distal humeral shaft fractures. An internet-based literature research was performed on Pubmed, Google Scholars and Cochrane Library. 265 patients were enrolled: 148 were treated by lateral or antero-lateral approach, while 117 by posterior or postero-lateral approach. The literature shows that no differences between the posterior and lateral approach exist. Certainly, the posterior approach offers undoubted advantages in terms of exposure of the fracture and visualization of the radial nerve. In our opinion, the posterior approach may also allow better management of complex and multi-fragmentary fractures.

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Published
2020-06-25
Keywords:
Distal humeral fracture, humeral complex fracture, humeral surgical approach, posterior humeral approach, lateral humeral approach.
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How to Cite
Saracco, M., Smimmo, A., De Marco, D., Palmacci, O., Malerba, G., Vitiello, R., Maccauro, G., Minutillo, F., & Rovere, G. (2020). Surgical approach for fracture of distal humerus: Posterior <em>vs</em&gt; lateral. Orthopedic Reviews, 12(1s). https://doi.org/10.4081/or.2020.8664

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