Distal Humerus-Case: Distal Humerus

Case: Distal Humerus

Pdf Summary

A 41-year-old female presented with left elbow pain and deformity after falling on ice. The injury was closed with no neurological or vascular deficits. For young, active patients, open reduction and stable internal fixation are recommended, with early motion. For elderly patients with poor bone quality, total elbow arthroplasty may be considered. Surgical considerations include a posterior approach and potential olecranon osteotomy for articular exposure and reduction. The ulnar nerve should be exposed, mobilized, and protected, but transposition is not necessary. Stable column fixation can be achieved with parallel plates or 90-90 plating. Postoperatively, a splint should be worn for 7-10 days, with sutures removed at the same time. Motion can start at 7-10 days and strengthening at 6 weeks. Expectations include a functional arc of motion, but some degree of terminal extension loss is expected. Overall, young patients with intra-articular distal humerus fracture require ORIF with possible olecranon osteotomy. The ulnar nerve should be exposed and mobilized, but transposition is not necessary. Stable fixation can be achieved with parallel plates or 90-90 plates, and early range of motion should be initiated. Functional range of motion is expected, but some terminal extension loss is likely.

Keywords

elbow pain

deformity

ORIF

early motion

total elbow arthroplasty

olecranon osteotomy

ulnar nerve

stable fixation

range of motion

terminal extension loss