RT Journal
A1 Sanchez-Sotelo, Joaquin
T1 Distal Humeral Fractures: Role of Internal Fixation and Elbow Arthroplasty
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD March 21
VO 94
IS 6
SP 555
OP 568
DO 10.2106/JBJS.946icl
UL http://dx.doi.org/10.2106/JBJS.946icl
AB 
The management of distal humeral fractures has evolved over the last few years. Worldwide application of the AO principles of plate and screw fixation during the late 1980s and early 1990s remained the only breakthrough for quite some time1. Recent major advancements in the management of these injuries include the widespread availability of computed tomography (CT) scans with three-dimensional reconstruction, recognition of the more complex articular shear fractures2, understanding the benefits of the parallel-plate technique3, the availability of precontoured periarticular plates, and the selective use of total elbow arthroplasty4. Opportunity for improvement remains, as reflected by the interest in distal humeral hemiarthroplasty for the treatment of these injuries and the controversy regarding the ideal management of the ulnar nerve as a part of this surgery and how to best manage structural bone loss. Unfortunately, insufficient internal fixation with Kirschner wires continues to be performed by some surgeons, greatly compromising patient outcome.