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Abstract
Objective: To compare the triceps-sparing VS triceps-splitting techniques in extra-articular distal humerus fractures in terms of mean range of motion (ROM) and mean disabilities of the arm, shoulder, and hand (DASH) Score.
Methods: A total of 124 patients who presented with isolated extra-articular distal humerus fractures were included in this randomized clinical trial (RCT). Patients were randomized into 2 groups; A and B, by generating random identity numbers using Microsoft excel for randomization. Group A underwent fixation using triceps-sparing approach while B patients operated using triceps-splitting approach. On the second day after surgery, the patient was discharged with detailed instructions for rehabilitation. The third follow-up took place three months after surgery, involving radiographic assessment of the elbow, measurement of the range of motion (ROM) using a goniometer, and evaluation with the Quick DASH score.
Results: The average age of the participants was 33.2±7.5 years. In terms of gender distribution, 77 participants (62.1%) were male, while 47 participants (37.9%) were female. The Triceps Sparing Group averaged 139 degrees ± 5, while the Triceps Split Group averaged 127 ± 4 degrees (p-value <0.0001). Additionally, the DASH score revealed a notable difference in functional outcomes; the Triceps Sparing Group had a mean score of 6.9 ± 3.1, compared to the Triceps Split Group's mean score of 11.8 ± 4.7 (p-value <0.0001).
Conclusion: Both the triceps-splitting and triceps-sparing techniques are viable options for treating extra-articular distal humerus fractures. Nevertheless, the triceps sparing approach tends to result in a markedly improved range of motion and DASH scores compared to the splitting method.