Management of distal humerus fractures.

Journal Article (Journal Article;Review)

Distal humeral fractures represent approximately 2% of fractures in adults and are often treated operatively to restore stable humeral columns and allow early elbow motion. Diagnosis is made with orthogonal radiographs. The traction view radiograph and computed tomography with three-dimensional reconstruction can be helpful in preoperative planning. Treatment options include: (1) nonoperative management, which is reserved for lower-demand, medically unwell, elderly patients, (2) surgical osteosynthesis, which remains the treatment of choice for most fractures, and (3) prosthetic replacement with either hemiarthroplasty or total elbow arthroplasty, which is indicated for distal complex comminuted fracture patterns in elderly, low-demand patients with poor bone quality. A thorough understanding of the anatomy around the elbow is critical when planning surgical approach and reduction. Controversies exist in the following areas: (1) surgical approach, (2) management of the ulnar nerve, (3) plating technique-parallel versus orthogonal, and (4) whether osteosynthesis or prosthetic elbow replacement is superior in the elderly population.

Full Text

Duke Authors

Cited Authors

  • Lauder, A; Richard, MJ

Published Date

  • July 2020

Published In

Volume / Issue

  • 30 / 5

Start / End Page

  • 745 - 762

PubMed ID

  • 31965305

International Standard Serial Number (ISSN)

  • 1633-8065

Digital Object Identifier (DOI)

  • 10.1007/s00590-020-02626-1

Language

  • eng

Conference Location

  • France