Publication: Osteosynthesis of intercondylar humerus fracture using bryan and morrey approach
Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal
articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, non-
union and implant related complications at the osteotomy site.
Objective: The aim of this study was to determine the functional outcome of displaced intra-articular distal humerus
fracture fixation using an alternative approach: the Bryan and Morrey approach.
Materials and methods: Twenty patients with twenty AO type C1 and C2 intercondylar fractures of the distal humerus
had bicolumnar fixation of the distal humerus with two contoured reconstruction plates and screws on the dorsal surface
or various combinations of a single reconstruction plate, screws and K-wires using a Bryan and Morrey approach.
Twelve of the patients were male and eight were female. The average age of the patients was 44.8 years. Eleven patients
had sustained the injury as result of fall and nine of the patients had sustained it in road traffic accidents. Right elbow
was involved in fifteen patients and left in five. All patients were followed up for 12 months post operatively.
Results: All twenty fractures had united at 4 months follow-up. The mean fixed flexion deformity was 9.0º (range 0º-
15º) and the mean arc of motion was 115.0º (range 85º- 130º). All patients had grade 4 triceps strength and stable elbows
at the end of 12 months follow up. One patient had deep seated wound infection resulting in necrosis of the triceps
tendon requiring a second operative procedure.
Conclusions: Bryan and Morrey approach is a simpler, easier and better approach as compared to the other posterior
approaches to the elbow joint, and therefore, can be used as the approach of choice for fixation of fractures of the distal
articular surface of humerus.
Key words: Fracture, Intercondylar Humerus, Osteosynthesis
Description
Lakhey S 1, Sharma S 1, Pradhan RL 1 , Pandey BK1, Manandhar RR 1, Rijal KP1
1 Department of Orthopaedics, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.