M.E.Müller: Atlas: Fracture 13-C2

Humerus, Distal, complete articular fracture, articular simple,
metaphyseal multifragmentary 0,22% of the total
3,03% of the femur
8,22% of the segment

42 fractures 35,3% group 30%M, 70%F

32 fractures
26,9% group
45%M, 55%F

45 fractures
37,8% group
34%M, 66%F

With an intact wedge +Q With a fragmented wedge +Q Complex

These are complete articular fractures of the distal humerus, involving the articular surface with a simple fracture line and the metaphysis with a wedge third fragment. Ref. Manual of Internal Fixation:
184 - 187. 204 - 208. 446 - 451
Surgeon. JG - CP, RO.

Anatomic reduction of the articular surface is mandatory. It is performed as the first surgical step and fixed with a cancellous lag screw. For a precise orientation of the screw, a Kirschner wire can be placed retrograde from the fracture site and reintroduced into the other fragment once the reduction is obtained. It is then substituted by a cannulated screw.

The metaphyseal fracture may be fixed with one or two plates, either one third tubular or reconstruction plates, placed in the posterolateral aspect or in the lateral borders of the distal humerus. Whenever possible (bone quality) we prefer to use pyramidally placed ascending screws, similar to the technique of Judet for supracondylar fractures in children, because it is less traumatic.

preoperative preoperative

+ 4 months + 4 months

preoperative preoperative

+ 4 months + 4 months

preoperative preoperative

+ 4 months + 4 months

preoperative preoperative

+ 3 months + 3 months

+ 1 year + 1 year

.. . ..

..

...

preoperative preoperative

+ 1 year + 1 year




						Humerus, Distal, complete articular fracture, articular simple, metaphyseal multifragmentary	0,22% of the total 3,03% of the femur 8,22% of the segment






These are complete articular fractures of the distal humerus, involving the articular surface with a simple fracture line and the metaphysis with a wedge third fragment.		Ref. Manual of Internal Fixation: 184 - 187. 204 - 208. 446 - 451 Surgeon. JG - CP, RO.

Anatomic reduction of the articular surface is mandatory. It is performed as the first surgical step and fixed with a cancellous lag screw. For a precise orientation of the screw, a Kirschner wire can be placed retrograde from the fracture site and reintroduced into the other fragment once the reduction is obtained. It is then substituted by a cannulated screw.	The metaphyseal fracture may be fixed with one or two plates, either one third tubular or reconstruction plates, placed in the posterolateral aspect or in the lateral borders of the distal humerus. Whenever possible (bone quality) we prefer to use pyramidally placed ascending screws, similar to the technique of Judet for supracondylar fractures in children, because it is less traumatic.