Comparison of Efficacy Between the Bilateral Triceps-Sparing and Olecranon Osteotomy Approaches With Double-Plate Internal Fixation for AO Type C3 Distal Humeral Fractures

For AO type C3 distal humeral fractures without metaphyseal defects, orthogonal double plating provides rigid fixation enabling early postoperative mobilization. For fractures with intact trochlear articular surfaces (no coronal/horizontal split) where fragments can be directly fixed by distal screws from the plates, the bilateral triceps approach may be prioritized. For severely comminuted trochlear fractures with articular fragmentation (coronal/horizontal split) requiring separate fixation of split fragments with headless compression screws, the olecranon osteotomy approach may provide better exposure.