Functional outcome of complex intercondylar fractures of the distal humerus treated through a triceps-sparing approach

Complex intra-articular fractures of the distal humerus (AO/ASIF type C) pose a significant challenge to the treating surgeon. This study aimed to review the functional outcome of these fractures managed with open reduction and internal fixation through a posterior triceps-sparing approach. Nine cases were treated over a 7-year period, with 7 patients available for review. Of note, the majority of cases were accompanied with significant associated injuries, including vascular and soft tissue trauma. A retrospective analysis of a consecutive series, managed by a single surgeon, was conducted at a mean follow-up period of 35.1 months (range, 6-78). The mean age was 41 years (range, 12-73). At the time of review, all fractures had united and the median arc was 90° (range, 70-115). All patients achieved good clinical scores as determined by the Mayo Clinic Performance Index. Quality of life assessment (SF-36) revealed no significant difference compared to the general population. The mean DASH score was 17.9, indicating mild residual impairment. There was no x-ray evidence of heterotopic ossification or post-traumatic osteoarthritis. The posterior triceps-sparing approach provides adequate exposure to the fracture site and allows early rehabilitation. Satisfactory functional outcome can be achieved for complex type C fractures of the distal humerus treated through this approach.