International Orthopaedics

, Volume 42, Issue 11, pp 2653–2662 | Cite as

Intra-articular fractures of the distal humerus—a review of the current practice

  • Charalampos G. ZalavrasEmail author
  • Efthymios Papasoulis


Intra-articular fractures of the distal humerus are complex injuries that can considerably limit elbow function if not treated appropriately. Surgical management is indicated for most intra-articular distal humerus fractures with the goal of restoring elbow range of motion and function. Open reduction and internal fixation (ORIF) with plates and screws has been the preferred surgical option. Double plating is recommended for bicolumnar fractures and plates can be applied either parallel or orthogonal to each other. Surgical approach for ORIF of the distal humerus can be performed through an olecranon osteotomy, but other approaches that preserve the olecranon are also in use, such as the triceps-reflecting, triceps-splitting, paratricipital, and triceps-reflecting anconeus pedicle approach. The ulnar nerve is identified during the approach, followed by either in situ decompression or anterior transposition. Elbow arthroplasty has also emerged as a viable alternative to ORIF for fixation of these fractures in elderly patients with poor bone quality.


Distal humerus Fracture Fixation Approach Ulnar nerve 


Compliance with ethical standards

Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Charalampos G. Zalavras
    • 1
    Email author
  • Efthymios Papasoulis
    • 1
  1. 1.Keck School of MedicineUniversity of Southern California, LAC+USC Medical CenterLos AngelesUSA

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