Pediatric Fractures of the Hand, Wrist, Forearm, and Elbow-Case: Distal Humerus Fractures

Case: Distal Humerus Fractures

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This document discusses distal humerus fractures, specifically focusing on their management and treatment. The case presented involves a 17-year-old female who suffered an intraarticular distal humerus fracture after a fall. The recommended method of management for this type of fracture is open reduction and internal fixation (ORIF). The first step in the treatment process is aligning the joint surface, followed by aligning the columns. Radiographs are shown before and after the procedure, demonstrating the successful healing of the fracture.<br /><br />Some key points to note about distal humerus fractures include the need for anatomic reduction and the importance of exposure, which is largely dependent on the fracture pattern. The posterior approach is often used as it allows access to both columns and is highly practical. <br /><br />In younger children, closed reduction and percutaneous pinning (CRPP) is the most common surgical technique for distal humerus fractures. However, when dealing with children who have closed physes (growth plates), these fractures should be treated more like adult elbows. Cross-screw fixation may be utilized in some cases, but there should be a low threshold for plating these more adult-like injuries.<br /><br />Overall, this document emphasizes the importance of proper management and treatment for distal humerus fractures, particularly in achieving anatomic reduction. It also highlights the approach and techniques used for different age groups, with a focus on younger children and those with closed growth plates.

Keywords

distal humerus fractures

management

treatment

ORIF

anatomic reduction

exposure

posterior approach

surgical technique

closed reduction

growth plates