Executive Editor: Chris Colton

Authors: Mariusz Bonczar, Daniel Rikli, David Ring

Distal humerus - Partial articular, medial sagittal, simple, through medial articular surface

back to skeleton

Glossary

General considerations

Nonoperative treatment is not indicated for intraarticular fractures of the distal humerus, unless there is a general contraindication to surgery.

All adult articular fractures of the distal humerus require open anatomical reduction and stable fixation.

Because adult elbows are notorious for becoming stiff after injury, the goal of operative treatment is anatomical reduction and stable fixation, especially of any joint fragments, so that active motion can be started within a few days of surgery.

Pediatric fractures are considered in Pediatric trauma of Surgery Reference.

ORIF - Screw fixation
Indication summary Skill Equipment
Surgeon’s preference Highly experienced and skilled surgeon Full specialized surgical and imaging resources

The choice between standard screw fixation and cannulated screw fixation is usually a question of the surgeon's individual preferences, the equipment available and the operative and imaging facilities.

Contraindications

  • Noncompliant patient
  • Unacceptable surgical risk
  • Extreme osteoporosis

Advantages

  • Anatomical reduction
  • Articular congruity
  • Early functional aftertreatment
  • Reduced risk of degenerate joint disease

Disadvantages

  • Risk of infection
  • Requirement for anesthesia
  • Cost
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2007-06-21