European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"The results of anterior cruciate ligament reconstruction with allograft versus autograft: a systematic review and meta-analysis.","authors":"Shilong Zhu, Rongxing Ma, Ruiqi Qiao, Jingyu Zhang, Yongcheng Hu","doi":"10.1007/s00590-025-04470-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04470-7","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior cruciate ligament (ACL) injury is a common sports-related injury that often requires surgical intervention. The two main types of grafts used in ACL reconstruction are autografts and allografts. Two types of transplants have their own advantages in different aspects, so the choice of graft type is a matter of ongoing debate among orthopedic surgeons. The purpose of this systematic review and meta-analysis is to compare the results of ACL reconstruction using allograft versus autograft.</p><p><strong>Methods: </strong>The Embase and PubMed databases were searched for clinical trial literature from January 1, 2000, to July 19, 2023, which met the individual inclusion criteria, for a meta-analysis of objective and subjective outcomes of the knee joint. Using random effects model, risk of bias was assessed using the Cochrane Collaboration's tools.</p><p><strong>Results: </strong>Thirteen studies and total of 1299 patients were included in the analysis. The pooled mean difference (MD) of subjective IKDC score was 2.14 (95% CI:1.43-2.85). The pooled MD of Lysholm score was 0.38 (95% CI:-1.25-2.02). The pooled MD of Tegner score was 0.23 (95% CI:0.03-0.43). The pooled relative risk (RR) of Lachman test was 1.32 (95% CI:0.95-1.82). The pooled RR of pivot shift test was 1.12 (95% CI:1.00-1.25). The pooled RR of objective IKDC was 1.03 (95% CI:1.01-1.05). In general, statistically significant differences in favor of autograft were observed for Subjective International Knee Documentation Committee score, Tegner score, pivot shift test and Objective International Knee Documentation Committee score, as for the Lysholm score and Lachman test there is no statistical differences between the two.</p><p><strong>Conclusion: </strong>From a majority of the outcome measures, autografts appear to have a slightly better effect compared to allografts. However, these slight differences in scores may not be reflected in clinical outcomes, indicating that there is not much superiority or inferiority between the two from the perspective of clinical outcomes. Therefore, in other fields such as humanities and economics, they are important factors for doctors to make choices in clinical practice.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"337"},"PeriodicalIF":1.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric oxygen therapy is effective and safe for femoral head osteonecrosis: a prospective midterm outcome study.","authors":"Sajid Ansari, Ankit Gaurav, Tushar Gupta, Parshwanath Bondarde, C H Raja Bhaskar Venkata Sri Madhusudan, Vishal Mago, Roop Bhushan Kalia","doi":"10.1007/s00590-025-04461-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04461-8","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to assess the effect of hyperbaric oxygen therapy (HBOT) on the radiological and clinical outcomes in patients with early Osteonecrosis of the femoral head (ONFH) at mid-term follow-up.</p><p><strong>Methods: </strong>A prospective observational study was conducted on patients with Osteonecrosis of the femoral head (ONFH). ONFH was diagnosed based on plain radiographs and MRI of the bilateral hips. ARCO stages 1-3A of ONFH patients were included with non-traumatic etiologies. Each patient received 5 sessions of HBOT per week for a total of 35 sessions. Repeat MRI was done within 6 weeks of completion of HBOT sessions, at 1 year and 2 years of follow-up. The pre-treatment and last follow-up (2 years) clinical (Harris Hip Scores, VAS Scores) and radiological parameters (JIC Classification, ARCO Staging, Modified Kerboul Angle, Bone marrow edema severity) were compared.</p><p><strong>Results: </strong>At the final follow-up, there was a significant improvement in the mean Harris Hip Score (p = 0.001) and VAS Score (p = 0.001). There was also a significant improvement in the JIC classification (p = 0.03), Modified Kerboul Angle (p = 0.001) and Bone marrow edema grading (p = 0.001) at the final follow-up.</p><p><strong>Conclusions: </strong>HBOT provides good clinical and radiological improvement and is an effective, safe, and non-invasive treatment for patients in the early stages of ONFH. Its role in the early collapse stage needs further validation by higher-level, prospective, large-scale RCTs.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"336"},"PeriodicalIF":1.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual tension band wiring for adolescent supracondylar fractures of the humerus: mechanical assessment and a clinical series.","authors":"Surasak Jitprapaikulsarn, Nattapon Chantarapanich, Theerachai Apivatthakakul, Pasin Lertvilai, Sujin Wanchat, Arthit Gromprasit, Pasit Sengpanich, Chantas Mahaisavariya, Yotakarn Saramas, Louis Paul Simonet","doi":"10.1007/s00590-025-04454-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04454-7","url":null,"abstract":"<p><strong>Background: </strong>The optimal fixation technique of adolescent supracondylar fractures of the humerus (A-SCFH) remains inconclusive. To prove the efficacy of Dual Tension Band Wiring (DTBW), the mechanical performance was compared to the other pinning constructs, i.e., Lateral Divergent Pining (LDP), Cross Pining (CP) and Dual CP. The clinical outcomes of the DTBW in A-SCFH were retrospectively described.</p><p><strong>Methods: </strong>Bone specimens with a supracondylar fracture acquired from computed tomography images of a patient were fabricated using a three-dimensional printing technique. The fracture was stabilized with pining techniques to create those four constructs. Each of constructs was mechanically tested under posterior bending, medial bending, lateral bending, and torsion. Maximum force, displacement at maximum force, maximum torque, rotational displacement at maximum torque, and construct stiffness were collected and calculated from the result of mechanical test. For the case series, 15 A-SCFH was operated on the DTBW. The reviewed data included time to union, perioperative complications, arc of elbow motion, Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) score.</p><p><strong>Results: </strong>The DTBW revealed a greater maximum force, and construct stiffness compared to the other constructs in most of the loading conditions. According to the case series, all fractures were consolidated with a mean union time of 7.2 weeks (range 6-10). By MEPS, all patients were determined to be good-to-excellent. The mean arc of elbow motion was 130 degrees (range 120-140) with a mean DASH score of 7.9 (range 2.5-17.5).</p><p><strong>Conclusion: </strong>By mechanical performance and clinical outcomes, the DTBW can be an effective and reliable technique in management of A-SCFH.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"335"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does polyangular double plating lead to less complications than monoaxial locking implants in the treatment of complex distal humerus fractures?","authors":"Johanna Habarta, Fabian Gilbert, Jan-Peter Grunz, Martin Jordan, Hendrik Jansen, Rainer Meffert, Jonas Schmalzl","doi":"10.1007/s00590-025-04465-4","DOIUrl":"https://doi.org/10.1007/s00590-025-04465-4","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"333"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total shoulder arthroplasty in patients with degenerative cervical spine disease: Does cervical spine surgery affect outcomes?","authors":"Mohammad Daher, Ryan Stadler, Peter Boufadel, Mohamad Y Fares, Alan H Daniels, Adam Khan, Brian Hill, John Horneff, Joseph Abboud","doi":"10.1007/s00590-025-04456-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04456-5","url":null,"abstract":"<p><strong>Background: </strong>Rates of both total shoulder arthroplasty (TSA) and cervical spine surgery for degenerative cervical spine disease (DCSD) are increasing. However, it is still unknown if prior cervical spine surgery for DCSD impact outcomes following TSA. This study aims to compare the risk of complications and revisions in patients undergoing TSA with DCSD between patients with and without prior cervical spine surgery.</p><p><strong>Methods: </strong>This study is a retrospective review of the PearlDiver Mariner Database. Based on whether or not patients had prior cervical spine surgery, the patients with DCSD and undergoing TSA were divided into 2 groups: patients with DCSD and cervical spine surgery, and patients with DCSD and without cervical spine surgery. The two groups were matched based on age, gender, the Charlson comorbidity index (CCI), and obesity. Surgical complications and revisions with regards to their TSA at 1 through 5 years post-operatively were compared between the groups.</p><p><strong>Results: </strong>The TSA with DCSD and no cervical spine surgery cohort were older (63.7 ± 8.4 vs 61.2 ± 8.4 years, p < .001), had higher CCI (1.2 ± 1.7 vs 1.0 ± 1.6, p < .001), had a higher proportion of males (47.8% vs 41.8%, p = 0.01), and had a lower % of patients with obesity (50.9% vs 53.3%, p = 0.01). After matching, 2899 patients remained in each group. The group with prior cervical spine surgery had higher rates of mechanical loosening at 5 years post-operatively (1.2% vs 1.8%, p = 0.05), and lower rates of periprosthetic fractures at 3 and 4 years post-operatively (0.4% vs < 10, p = 0.01; 0.5% vs < 10, p = 0.02 respectively). No difference in the remaining surgical complications or revisions was seen between the two groups.</p><p><strong>Conclusion: </strong>This study highlights an increase in risk of mechanical loosening after TSA in patients with prior cervical spine surgery. Additionally, patients with DCSD without prior cervical spine surgery had an increased risk of sustaining periprosthetic fractures after TSA, potentially due to untreated myelopathy and related falls.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"332"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic extensor tendon repairs: is the operating room necessary? A comparative study.","authors":"Tal Frenkel Rutenberg, Efrat Daglan, Sorin Daniel Iordache, Yona Kosashvili, Tuna Ozyurekoglu","doi":"10.1007/s00590-025-04457-4","DOIUrl":"https://doi.org/10.1007/s00590-025-04457-4","url":null,"abstract":"<p><strong>Purpose: </strong>Extensor tendon injuries (ETI) are common. Injuries which involve more than half of the tendon width should be repaired. We aimed to compare the results of ETI repairs performed upon presentation in an emergency department (ED) minor procedure room (MPR) to those performed in the operating room (OR).</p><p><strong>Methods: </strong>A retrospective study comparing a cohort of consecutive patients treated for ETI in an OR between 2018 and 2023 to a cohort of consecutive patients treated for ETI in an ED MPR between 2019 and 2022 was reviewed. The demographics, mechanism and characteristics of injuries and results were compared. Files were reviewed for 90 days for postoperative complications.</p><p><strong>Results: </strong>One hundred and thirteen patients (147 tendons) were treated in the OR and 179 patients (203 tendons) were treated in the ED MPR. Patients' demographics and injury mechanism were similar. A higher rate of patients treated in the OR presented with complete tears. The zone of injury differed between groups, but zone V was most frequent in both. No intraoperative complications were encountered. Postoperative complication rates were alike, with 4.4% of patients from the OR cohort and 1.7% patients from the MPR cohort presenting with postoperative infection (p = 0.268). Patients treated in the OR had a longer delay for surgery, a longer length of stay and received more opioid prescriptions.</p><p><strong>Conclusions: </strong>Extensor tendon repairs performed at an ED MPR have comparable outcomes to repairs performed in the OR. The ED MPR setting might reduce medical costs, and it is associated with a shorter length of stay.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"334"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and outcomes of radial nerve palsy in distal third diaphyseal humerus fractures after surgical fixation.","authors":"Jacquelyn P Cruz, Maxwell Durtschi, Christen Chalmers, Andrew Belk, Andrea Finlay, Sandhya R Chandar, Carina L Tedesco, John Scolaro, L Henry Goodnough, Julius A Bishop, Michael J Gardner","doi":"10.1007/s00590-025-04462-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04462-7","url":null,"abstract":"<p><strong>Background: </strong>Radial nerve palsy (RNP) is a common complication of diaphyseal humerus fractures, with primary RNP rates varying by fracture location. However, the relationship between fracture location and the risk of secondary RNP following surgical fixation remains unclear. This study aimed to evaluate the incidence of postoperative RNP based on fracture location within the middle and distal thirds of the humeral diaphysis and to describe the outcomes of RNP over time.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of patients undergoing open reduction and internal fixation for middle and distal third diaphyseal humerus fractures at two Level 1 trauma centers from 2011 to 2023. Patients with proximal third fractures, pathologic fractures, or intramedullary nailing were excluded. Fracture location, surgical approach, and neurovascular outcomes were recorded. Differences between groups were analyzed using ANOVA and Fisher's exact tests.</p><p><strong>Results: </strong>A total of 164 fractures met inclusion criteria. Postoperative RNP occurred in 8% of middle third fractures, 14% of distal third fractures, and 23% of middle-distal third fractures (p = 0.18). Preoperative RNP was significantly more common in middle-distal third fractures (38%) compared to middle third (21%) or distal third fractures (16%) (p = 0.02). At final follow-up, 49% of preoperative RNPs and 78% of postoperative RNPs had resolved, with postoperative RNPs significantly more likely to recover (p = 0.048). No significant differences in RNP resolution were observed based on fracture location.</p><p><strong>Conclusion: </strong>Fracture location within the middle or distal third of the humeral diaphysis was not associated with a significant difference in the incidence of postoperative radial nerve palsy following surgical fixation. Postoperative RNP demonstrated a high rate of recovery, supporting conservative management in most cases.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Cohort Study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"330"},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of revision surgery with reconstruction for patellar tendon re-rupture: a case series study.","authors":"Rodrigo Olivieri, Tomás Pineda, Tania Rojas, José Laso, José Tomás Muñoz, Nicolás Gaggero, Nicolás Franulic, Jaime Ugarte","doi":"10.1007/s00590-025-04466-3","DOIUrl":"https://doi.org/10.1007/s00590-025-04466-3","url":null,"abstract":"<p><strong>Purpose: </strong>Patellar tendon ruptures are infrequent but disabling injuries. Surgical treatment is the gold standard to obtain good outcomes. Failure of primary repair is a catastrophic complication. The literature regarding patellar tendon re-ruptures is very limited. The purpose of the current study was to evaluate the outcomes of a series of patients who underwent revision surgery for re-rupture of the primary patellar tendon repair.</p><p><strong>Methods: </strong>All patients with patellar tendon re-rupture surgically intervened in our center between 2019 and 2023 were retrospectively reviewed. Patient characteristics, surgical technique, functional and radiological outcomes, and complications were recorded.</p><p><strong>Results: </strong>Five patients with patellar tendon re-rupture were included, all of whom were male. The mean follow-up period was 30 months. The average age was 54.4 years. Patellar tendon reconstruction was performed in four cases using allografts and in one case using an autograft. The average Lysholm and Kujala scores were 88.8 and 86.8, respectively, while the mean Insall-Salvati and Caton-Deschamps indices were 1.07 at the end of the follow-up. No cases of re-rupture of the reconstructed patellar tendon were observed.</p><p><strong>Conclusions: </strong>In this case series of patients with patellar tendon re-rupture, revision surgery with reconstruction using autograft or allograft is presented as a valid alternative, with good functional and radiological outcomes at medium-term follow-up.</p><p><strong>Level of evidence: </strong>Case Series Study (Level IV).</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"331"},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-patient comparison of trapeziectomy with LRTI and dual mobility prosthesis for trapeziometacarpal osteoarthritis: a multicenter observational study.","authors":"Francesco Smeraglia, Enrico Carità, Giulia Frittella, Federico Tamborini, Lorenzo Diaz, Alberto Donadelli, Matteo Guzzini","doi":"10.1007/s00590-025-04441-y","DOIUrl":"10.1007/s00590-025-04441-y","url":null,"abstract":"<p><strong>Purpose: </strong>Thumb osteoarthritis is a debilitating condition that affects a large portion of the elderly population. Conservative treatments for this condition often fail, and a surgical solution is required. Many different surgical techniques have been described, but the current literature has not yet demonstrated the superiority of one over the others. In this study, we analyzed the clinical and radiological findings of a population of 26 patients who were operated on both hands but with different techniques.</p><p><strong>Methods: </strong>One hand underwent trapeziectomy with suspension arthroplasty, while the other hand was operated on with a double mobility trapeziometacarpal prosthesis.</p><p><strong>Results: </strong>Our findings show that, while on the long-term follow-up the two techniques are equally valid, in the short term, the hands that were operated on with the prosthesis had a faster recovery of strength and pain.</p><p><strong>Conclusion: </strong>Therefore, we reckon that double mobility trapeziometacarpal prostheses are a better choice of treatment, especially for patients who require a faster recovery for work or leisure activities.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"329"},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triceps-sparing versus triceps-splitting approaches for OTA 12A-C and 13A2-3 distal-third humeral shaft fractures have similar 1 year functional outcomes.","authors":"Abhishek Ganta, Amelia Goldstein, Bradley Lezak, Hillary Campbell, Kenneth Egol, Sanjit Konda","doi":"10.1007/s00590-025-04448-5","DOIUrl":"10.1007/s00590-025-04448-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare functional outcomes of distal third humeral shaft fractures (OTA 12A-C and 13A2-3) treated with either triceps-splitting or triceps-sparing surgical approach. Secondarily, the purpose was to compare healing and complication rates between the two surgical approaches.</p><p><strong>Method: </strong>A retrospective review of a prospectively collected humeral shaft registry was performed from 01/2018-12/2024. Inclusion criteria was: age > 18yo, OTA 12A-C or 13A2-3 distal third humeral shaft fracture, either triceps-splitting or triceps-sparing surgical approach, and minimum 1-year follow-up. The primary outcome was 1-year postoperative functional status measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Secondary outcomes measures included surgical time, radiographic union times, union rates, iatrogenic nerve injury, fracture related infection, hardware failure, reoperation, and documented range of motion (ROM) at last follow-up. Univariate analysis with two-tailed Student's t-tests and chi-square tests was used to compare demographics, injury and surgical characteristics.</p><p><strong>Result: </strong>A total of 39 patients met inclusion criteria: 27 (69.2%) underwent a triceps-splitting approach and 12 (30.8%) a triceps-sparing approach. There were no significant differences in baseline demographics. At final follow-up, functional outcomes were comparable. DASH scores were similar between groups (7.7 ± 13.8 vs 7.0 ± 9.0, p = 0.89), as were fracture healing times (5.5 ± 2.2 vs 6.1 ± 3.6 months, p = 0.63), with all fractures achieving union. Surgical duration was shorter in the splitting group (83 ± 42 vs 103 ± 52 min, p = 0.26), though not statistically significant. No hardware-related complications were reported. Two radial nerve palsies (7.6%) occurred in the splitting group, while one postoperative infection (8.3%) occurred in the sparing group (all p > 0.05). Elbow range of motion was similar. Mean flexion was 137.9 ± 10.0° in the splitting group vs 131.3 ± 30.0° in the sparing group (p = 0.47); mean extension was 2.3 ± 4.7° vs 4.6 ± 5.5°, respectively (p = 0.21).</p><p><strong>Conclusion: </strong>There is no difference in 1-year functional outcomes as measured by the DASH score between the triceps-splitting versus triceps-sparing approach for surgical fixation of the OTA 12A-C and 13A2-3 distal third humeral shaft fractures. Either surgical approach is viable for distal third humeral shaft fractures.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"328"},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}