50 cases of intra-articular fractures of distal humerus (both T and Y types) collected over a period of four years (1993-1997) were admitted in orthopedic ward of Sandeman Provincial Hospital (Teaching Hospital) Quetta and Mansoor Orthopedic Hospital, Zarghoon Road Quetta. Out of these fifty cases, eight were admitted in neuro-surgical unit. Among these fifty patients 6 did not complete the study including the two who died due to severe head injury. Forty-four of these fifty patients who had fractures of distal humerus and treated by open reduction and internal fixation by two different surgical approaches i.e. Triceps Tongue Approach, Trans-olecranon Approach; Comparison of Results both Groups have done which formed the bases of this study. CONCLUSION: Transolecranon is a better approach than triceps splitting or triceps tongue flap approach. In transolecranon approach there is less stripping of soft tissues and good exposure of the fractured fragments, for anatomical reduction and stable internal fixation. Postoperatively there is less fibrosis of soft tissue and rehabilitation is easy.
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