Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4318-4326
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4318
Lateral epicondyle osteotomy approach for coronal shear fractures of the distal humerus: Report of three cases and review of the literature
Jie Li, Vidmi Taolam Martin, Zhi-Wen Su, Dong-Tai Li, Qi-Yi Zhai, Bo Yu
Jie Li, Vidmi Taolam Martin, Zhi-Wen Su, Dong-Tai Li, Qi-Yi Zhai, Bo Yu, Department of Orthopedics, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China
Author contributions: Yu B was responsible for the patients’ surgical treatment; Martin VT, Su ZW, Li DT, and Zhai QY were part of the surgical team; Li J drafted the manuscript; all authors read and approved the final manuscript; all authors helped collect the data and write and revise the manuscript.
Informed consent statement: All patients gave their informed consent.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CAREChecklist-2016.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Yu, MD, PhD, Assistant Professor, Department of Orthopedics, Zhujiang Hospital of Southern Medical University, No. 253 Industrial Avenue Middle Street, Haizhu District, Guangzhou 510282, Guangdong Province, China. gzyubo@163.com
Received: January 13, 2021
Peer-review started: January 13, 2021
First decision: February 11, 2021
Revised: February 24, 2021
Accepted: April 2, 2021
Article in press: April 2, 2021
Published online: June 16, 2021
Processing time: 133 Days and 6.8 Hours
Abstract
BACKGROUND

Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to manage. Open reduction and internal fixation (ORIF) has become the preferred treatment because it provides anatomical reduction, stable internal fixation, and early motion, but the optimal surgical approach remains controversial.

CASE SUMMARY

We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via a novel surgical approach, in which lateral epicondyle osteotomy was performed based on the extended lateral approach. We named the novel surgical approach the lateral epicondyle osteotomy approach. All patients underwent surgical treatment and were discharged successfully. All patients had excellent functional results according to the Mayo elbow performance score. The average range of motion was 118° in flexion/extension and 172° in pronation/ supination. Only case 2 had a complication, which was implant prolapse.

CONCLUSION

We demonstrated that the lateral epicondyle osteotomy approach in ORIF is effective and safe for coronal shear fractures of the distal humerus.

Keywords: Distal humerus fracture; Coronal shear fracture; Lateral epicondyle; Surgical approach; Osteotomy; Case report

Core Tip: Coronal shear fractures of the distal humerus are rare and technically challenging to manage. Open reduction and internal fixation (ORIF) has become the preferred treatment, but the optimal surgical approach remains controversial. We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via the lateral epicondyle osteotomy approach, in which lateral epicondyle osteotomy was performed based on the extended lateral approach. Our management experience in the three cases demonstrated the effectiveness and safety of this novel approach.