M.E.Müller: Atlas: Fracture 13-B3

Humerus, Distal,
partial articular fracture,
frontal 0,12% of the total
1,71% of the femur
4,63% of the segment

39 fractures 58,2% group 32%M, 68%F

5 fractures
7,5% group
0%M, 100%F

23 fractures 34,3% group
19%M, 81%F

Capitellum +Q Trochlea +Q Capitellum and trochlea

These are transarticular frontal plane fractures of the distal humerus. The subgroups are determined by the involvement of the capitellum, the trochlea or both. Ref. Manual of Internal Fixation:
184 - 187. 446 - 449.
Surgeon. RO, MS, CB, AG.

The main difficulty in deciding the type of treatment is to evaluate the possible avascular necrosis of the free fragment, only avoidable by a perfect reduction and compression.

In the fractures of the capitellum, the simple excision of the fragment offers good results if the elbow remains stable (integrity of the medial collateral ligament). If the

fragment is to be retained, it must be precisely reduced and fixed with a lag screw (two screws in large bones) placed from posterior to anterior or from anterolateral to posterior.

In the trochlear fractures (case at bottom, B3.3) it is mandatory to reduce and fix the free fragment with lag screws placed from posterior to anterior.

preoperative

+ 4 months + 4 months

preoperative

+ 4 months + 4 months

preoperative

+ 4 months + 4 months

preoperative

+ 1 year + 1 year

preoperative preoperative

0 months 0 months




						Humerus, Distal, partial articular fracture, frontal	0,12% of the total 1,71% of the femur 4,63% of the segment






These are transarticular frontal plane fractures of the distal humerus. The subgroups are determined by the involvement of the capitellum, the trochlea or both.		Ref. Manual of Internal Fixation: 184 - 187. 446 - 449. Surgeon. RO, MS, CB, AG.

The main difficulty in deciding the type of treatment is to evaluate the possible avascular necrosis of the free fragment, only avoidable by a perfect reduction and compression. In the fractures of the capitellum, the simple excision of the fragment offers good results if the elbow remains stable (integrity of the medial collateral ligament). If the	fragment is to be retained, it must be precisely reduced and fixed with a lag screw (two screws in large bones) placed from posterior to anterior or from anterolateral to posterior. In the trochlear fractures (case at bottom, B3.3) it is mandatory to reduce and fix the free fragment with lag screws placed from posterior to anterior.