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Background::The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy n vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.n Methods::The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.Results::Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75;n P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI:-2.56 to 2.89; n P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; n P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; n P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; n P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.n Conclusions::This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.“,”Background::The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy n vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.n Methods::The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.Results::Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75;n P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI:-2.56 to 2.89; n P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; n P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; n P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; n P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.n Conclusions::This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.