Abstract
Fractures of the distal humerus are challenging, and reconstruction of those fractures should be performed in centers with upper extremity surgery. This chapter covers the treatment of AO type B3 and type C fractures.
Depending on the fracture type and fracture pattern as well as the age and demand of the patient, different procedures are available for fracture reconstruction. Screw osteosynthesis and preformed angular locking plate osteosynthesis are options for reconstruction. In cases with non-reconstructable fractures, arthroplasty is an option. This option should be reserved for elderly, low-demand patients. Nonsurgical treatment should be reserved for moribund patients.
Different approaches for the visualization of the distal humerus are available.
An olecranon osteotomy facilitates the visualization and reduction of the fracture pattern of the articular surface but should be avoided if not necessary.
A neurolysis of the ulnar nerve should be performed to avoid nerve damage during reconstruction. In cases with preoperative ulnar nerve symptoms, an anterior transposition of the ulnar nerve is obligatory.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Robinson CM, Hill RMF, Jacobs N, Dall G, Court-Brown CM. Adult distal humeral metaphyseal fractures: epidemiology and results of treatment. J Orthop Trauma. 2003;17(1):38–47.
Dubberley JH, Faber KJ, Macdermid JC, Patterson SD, King GJW. Outcome after open reduction and internal fixation of capitellar and trochlear fractures. J Bone Joint Surg Am. 2006;88(1):46–54.
Dey Hazra RO, Lill H, Jensen G, Imrecke J, Ellwein A. Frakturspezifische Therapiekonzepte der distalen Humerusfraktur. Obere Extremitat. 2018;13(1):23–32. https://doi.org/10.1007/s11678-018-0442-8. Springer. Epub 2018 Feb 15
Aitken SA, Jenkins PJ, Rymaszewski L. Revisiting the “bag of bones”: functional outcome after the conservative management of a fracture of the distal humerus. Bone Joint J. 2015;97-B(8):1132–8.
Caravaggi P, Laratta JL, Yoon RS, De Biasio J, Ingargiola M, Frank MA, et al. Internal fixation of the distal humerus: a comprehensive biomechanical study evaluating current fixation techniques. J Orthop Trauma. 2014;28(4):222–6.
Zalavras CG, Vercillo MT, Jun B-J, Otarodifard K, Itamura JM, Lee TQ. Biomechanical evaluation of parallel versus orthogonal plate fixation of intra-articular distal humerus fractures. J Shoulder Elb Surg. 2011;20(1):12–20.
Penzkofer R, Hungerer S, Wipf F, von Oldenburg G, Augat P. Anatomical plate configuration affects mechanical performance in distal humerus fractures. Clin Biomech (Bristol, Avon). 2010;25(10):972–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Uschok, S., Hackl, M., Wegmann, K., Müller, L.P. (2022). Intra-articular Supracondylar Humerus Fractures. In: Geissler, W.B. (eds) Wrist and Elbow Arthroscopy with Selected Open Procedures. Springer, Cham. https://doi.org/10.1007/978-3-030-78881-0_70
Download citation
DOI: https://doi.org/10.1007/978-3-030-78881-0_70
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-78880-3
Online ISBN: 978-3-030-78881-0
eBook Packages: MedicineMedicine (R0)