Abstract

Background: Fixation of intra-articular distal humerus fractures has remained a
challenge to orthopaedic surgeons due to complicated anatomy of elbow, comminution
at fracture site and osteopenia of articular surfaces. We aimed to evaluate the functional
outcomes and complications after dual plating for distal humerus fractures with triceps
tongue technique. Materials and Methods: We conducted a retrospective study which
consisted of 20 cases of distal humerus fracture with intraarticular extension and
treated with open reduction and internal fixation with dual column plating using triceps
tongue technique. Triceps Tongue approach allows exposure of distal humerus articular
surface by forming an inverted V-shaped flap of distal triceps at the musculotendinous
junction. Results: Union was achieved in all cases. Mean time of fracture union was
14.65±1.82 weeks. There was no case of non-union although elbow stiffness occurred in
one patient. The mean MEPS score was 83.45±9.18 with a range of 70-95. Conclusion:
Triceps Tongue approach is a simple and less technically demanding approach for the
surgeon that can be used in management of the majority of the distal humeral fractures,
giving adequate exposure of the surgical field, aiding in proper reduction of fracture
fragments and thus obviating the need for an olecranon osteotomy