000165991 001__ 165991
000165991 005__ 20260119151009.0
000165991 0248_ $$2sideral$$a147394
000165991 037__ $$aART-2020-147394
000165991 041__ $$aeng
000165991 100__ $$0(orcid)0000-0003-1114-4045$$aBallesteros-Betancourt, J.R.
000165991 245__ $$aThe anterior limited approach of the elbow for the treatment of capitellum and trochlea fractures: Surgical technique and clinical experience in eight cases
000165991 260__ $$c2020
000165991 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165991 5203_ $$aWhen a coronal fracture affects the capitellum and the trochlea, the Kocher lateral approach may be inadequate for the correct visualisation, reduction and fixation of the fracture. In such cases an associated medial elbow approach may be required, or a posterior transolecranon approach may be preferred. The anterior limited approach to the elbow (ALAE) could be a valid option when treating these types of fracture, as it does not involve the detachment of any muscle group or ligament, thereby facilitating the recovery process. We can also treat associated injuries such as fractures of the radial head or coronoid process with this approach.
We describe the surgical technique and the functional outcome of eight patients with a mean of 66 years (range, 53-76) who where treated with open reduction and internal fixation for capitellar and trochlear fractures through the ALAE. Patient outcomes were assessed with physical and radiological evolution, range-of-motion measurements with a follow-up from 24 to 60 months. Two different quality of life questionnaires were carried out: the EuroQol Five Dimensions Questionnaire (EQ-5D) and the patient-answered questionnnaire of the Liverpool Elbow Score patient (PAQ-LES).
Four fractures involved the capitellum, one involved the capitellum with the lateral ridge of the trochlea, and three involved the capitellum and trochlea as separate fragments. The patients presented a favorable clinical evolution at a median of 33 months (range, 24-60), with an average of motion of 10-138 degrees. Four patients presented a fracture of the head of the radius (Mason type 2) and 3 fractures of the coronoid (Bryan-Morrey Type 1) associated. All the patients presented radiological consolidation without signs of osteonecrosis, being the average EQ-5D 0.857 (range, 0.36-1.0) and the PAQ-LES of 35 (range 17 to 36).
Patients with isolated capitellar fractures had better results than those with trochlear involvement. The presence of associated fractures does not seem to worsen the results. We believe that the ALAE is a technical option to consider for the open surgical treatment of a capitellar fracture with or without involvement of the trochlea.
000165991 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000165991 590__ $$a2.586$$b2020
000165991 591__ $$aEMERGENCY MEDICINE$$b12 / 32 = 0.375$$c2020$$dQ2$$eT2
000165991 591__ $$aORTHOPEDICS$$b38 / 81 = 0.469$$c2020$$dQ2$$eT2
000165991 591__ $$aSURGERY$$b96 / 210 = 0.457$$c2020$$dQ2$$eT2
000165991 591__ $$aCRITICAL CARE MEDICINE$$b25 / 36 = 0.694$$c2020$$dQ3$$eT3
000165991 592__ $$a0.966$$b2020
000165991 593__ $$aEmergency Medicine$$c2020$$dQ1
000165991 593__ $$aSurgery$$c2020$$dQ1
000165991 593__ $$aOrthopedics and Sports Medicine$$c2020$$dQ1
000165991 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000165991 700__ $$aGarcía-Tarriño, R.
000165991 700__ $$aGarcía-Elvira, R.
000165991 700__ $$aMuñoz-Mahamud, E.
000165991 700__ $$aFernández-Valencia, J.A.
000165991 700__ $$aLlusá-Pérez, M.
000165991 700__ $$aCombalia-Aleu, A.
000165991 773__ $$g51, S (2020), 103 - 111$$pInjury$$tInjury$$x0020-1383
000165991 8564_ $$s199043$$uhttps://zaguan.unizar.es/record/165991/files/texto_completo.pdf$$yPostprint
000165991 8564_ $$s1506774$$uhttps://zaguan.unizar.es/record/165991/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000165991 909CO $$ooai:zaguan.unizar.es:165991$$particulos$$pdriver
000165991 951__ $$a2026-01-19-15:09:34
000165991 980__ $$aARTICLE