M.E.Müller: Atlas: Fracture 13-B1

Humerus, Distal,
partial articular fracture,
sagittal lateral condyle 0,38% of the total
5,36% of the femur
15,51% of the segment

71 fractures 33,8% group 67%M, 33%F

85 fractures
40,5% goruo
62%M, 38%F

54 fractures 25,7% group
45%M, 55%F

Capitellum +Q Transtrochlear simple +Q Transtrochlear multifragmentary +Q

These are lateral sagittal transarticular fractures of the distal humerus. The subgroups are determined by the involvement of the capitellum (B1.1), the trochlea simple (B1.2) or multifragmentary (B1.3). Ref. Manual of Internal Fixation:
184 - 187. 446 - 451.
Surgeon. RO, RO.

Since these are articular fractures, anatomic reduction is mandatory. The prevalence of cortical bone in this segment allows internal fixations “ad minimum”. One screw, well placed with biomechanical sense, may be enough to obtain stability of the fragment.

The B1.3 case corresponds to a multiple injury patient and, because of the poor quality of the preoperative x-rays, the fracture could only be adequately classified at surgery. The fracture line that ascends through the metaphysis must be anatomically reduced. It was

stabilized with a one-third tubular plate, contoured, through which the distal screws exert a lag screw effect. Following careful reduction of the several trochlear fragments, fixation and interfragmentary compression is obtained by one isolated metaphyseal screw inserted distally to the plate. This is possible because of the prevalence of cortical bone in the fragments of this area that, once reduced and compressed, will not suffer deformation and will maintain their stability even with early motion of the elbow.

preoperative + 4 months + 4 months

preoperative preoperative

+ 5 months + 5 months




						Humerus, Distal, partial articular fracture, sagittal lateral condyle	0,38% of the total 5,36% of the femur 15,51% of the segment






These are lateral sagittal transarticular fractures of the distal humerus. The subgroups are determined by the involvement of the capitellum (B1.1), the trochlea simple (B1.2) or multifragmentary (B1.3).		Ref. Manual of Internal Fixation: 184 - 187. 446 - 451. Surgeon. RO, RO.

Since these are articular fractures, anatomic reduction is mandatory. The prevalence of cortical bone in this segment allows internal fixations “ad minimum”. One screw, well placed with biomechanical sense, may be enough to obtain stability of the fragment. The B1.3 case corresponds to a multiple injury patient and, because of the poor quality of the preoperative x-rays, the fracture could only be adequately classified at surgery. The fracture line that ascends through the metaphysis must be anatomically reduced. It was	stabilized with a one-third tubular plate, contoured, through which the distal screws exert a lag screw effect. Following careful reduction of the several trochlear fragments, fixation and interfragmentary compression is obtained by one isolated metaphyseal screw inserted distally to the plate. This is possible because of the prevalence of cortical bone in the fragments of this area that, once reduced and compressed, will not suffer deformation and will maintain their stability even with early motion of the elbow.