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Intra-articular fractures of the distal humerus—a review of the current practice

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Abstract

Intra-articular fractures of the distal humerus are complex injuries that can considerably limit elbow function if not treated appropriately. Surgical management is indicated for most intra-articular distal humerus fractures with the goal of restoring elbow range of motion and function. Open reduction and internal fixation (ORIF) with plates and screws has been the preferred surgical option. Double plating is recommended for bicolumnar fractures and plates can be applied either parallel or orthogonal to each other. Surgical approach for ORIF of the distal humerus can be performed through an olecranon osteotomy, but other approaches that preserve the olecranon are also in use, such as the triceps-reflecting, triceps-splitting, paratricipital, and triceps-reflecting anconeus pedicle approach. The ulnar nerve is identified during the approach, followed by either in situ decompression or anterior transposition. Elbow arthroplasty has also emerged as a viable alternative to ORIF for fixation of these fractures in elderly patients with poor bone quality.

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  1. Keck School of Medicine, University of Southern California, LAC+USC Medical Center, 1200 N State St, GNH 3900, Los Angeles, CA, 90033, USA

    Charalampos G. Zalavras & Efthymios Papasoulis

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Zalavras, C.G., Papasoulis, E. Intra-articular fractures of the distal humerus—a review of the current practice. International Orthopaedics (SICOT) 42, 2653–2662 (2018). https://doi.org/10.1007/s00264-017-3719-4

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