Abstract:

BACKGROUND: Selection of internal fixation and inserted approach is important to the successful treatment of adult humeral intercondylar fractures.
OBJECTIVE: To review the clinical outcome of Y-shaped plate internal fixation and double plate internal fixation for humeral intercondylar fractures through different operative approaches.
METHODS: Open reduction and internal fixation using plate were performed in 139 cases with humeral intercondylar fracture, of which triceps splitting was carried out in 22, bilateral triceps was carried out in 46, triceps V shaped severance was carried out in 27, and olecranon osteotomy in 44. All patients were followed up for 3-48 months, and the results were scaled according to Aitken and Rorabeck Elbow Score standard. 
RESULTS AND CONCLUSION: The excellent and satisfactory rate of two internal fixation methods showed statistical difference (P < 0.05) by olecranon osteotomy approach, bilateral triceps approach, and triceps splitting approach; while no statistical difference ( P > 0.05) by triceps V shaped severance approach. But the excellent and satisfactory rate of the senior three operative approaches in double plate internal fixation compared with triceps V shaped severance approach showed statistical difference (P  < 0.05), while no statistical difference (P  > 0.05)in comparison with each other. The clinical outcome of humeral intercondylar fractures treated with double plate internal fixation was superior to those treated with Y-shaped plate internal fixation. Meanwhile, triceps splitting approach, olecranon osteotomy approach and bilateral triceps approach can obtain the same clinical outcome for humeral intracondylar fractures, and the clinical outcomes of all three operative approaches are superior to those of triceps V shaped severance approach.