Type C distal humeral fracture is mostly caused by violence, resulting in the separation and displacement of medial and lateral condyle of humerus and the destruction of joint surface, and type C3 fracture is one of the most serious ones. Due to multiple layers of posterior tissue coverage, fracture exposure reduction and fixation are difficult, so the treatment of type C3 fracture is challenging.

To investigate the effectiveness analysis of bilateral approach via triceps and double plates internal fixation for type C3 (AO/OTA) distal humeral fractures.

From January 2016 to December 2019, 32 patients (17 males and 15 females) with type C3 distal humeral fractures were admitted to Sichuan Provincial People's Hospital and its branch. The ages ranged from 28 to 79 years, with an average age of (40.3±4.8) years. There were 19 on the left side and 13 on the right side. All patients were treated with double plates internal fixation through bilateral approaches. The operation time, blood loss, fracture healing time, elbow joint and forearm activities in the 3rd month after operation were recorded. The recovery of elbow function was evaluated by the Mayo elbow function score (MEPS) in the 6th month postoperatively. The complications were recorded during follow-ups.

All patients were followed up for (8.4±1.9) months (6-12 months) . All patients were successfully operated. The operation duration was (92.0±10.2) min, the blood loss was (205±23) ml, and the fracture healing time was (4.0±1.2) months. In the 3rd month after operation, the range of flexion and extension of elbow joint was 75°to 130° (104.1±10.5) °, and the range of forearm rotation was 95° to 180° (121.6±17.5) °. In the 6th month after operation, the MEPS score of the affected elbow was (84.6±2.3) points. There were 10 excellent cases, 16 good cases, 3 moderate cases, and 3 poor cases, and the excellent and good rate was 81.3% (26/32) . During the follow-up period, there were no complications such as internal fixation failure and ulnar nerve injury. However, 3 patients developed myositis ossificans.

The bilateral approaches via triceps meet the requirements of operative field exposure in the treatment of type C3 distal humeral fracture with double plates. It is convenient for fracture reduction and internal fixation, and preserves the continuity of triceps for elbow function recovery.