Are olecranon osteotomies preferred to triceps-elevating approaches in intraarticular distal humerus fractures? A literature review

The outdated ‘bag of bones’ concept for managing intraarticular distal humerus fractures (IDHF) has historically given way to precise articular reduction made possible by modern implant designs and the option of joint replacement as a last resort for unreconstructable fractures. Several posterior approaches to the distal humerus have been described since the last century, among which the olecranon osteotomy is considered the most invasive yet the most employed approach in cases of intraarticular distal humerus fractures. The advantages and reported complications of the triceps fascial tongue approach, the triceps reflecting anconeus pedicle (TRAP) approach, and the olecranon osteotomy in cases of intraarticular distal humerus fractures were the subjects of a thorough literature search in the PubMed, SCOPUS, Cochrane Library, and Google Scholar databases. This literature review made use of all pertinent data.