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Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 5/2020

21.01.2020 | General Review

Management of distal humerus fractures

verfasst von: Alexander Lauder, Marc J. Richard

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2020

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Abstract

Distal humeral fractures represent approximately 2% of fractures in adults and are often treated operatively to restore stable humeral columns and allow early elbow motion. Diagnosis is made with orthogonal radiographs. The traction view radiograph and computed tomography with three-dimensional reconstruction can be helpful in preoperative planning. Treatment options include: (1) nonoperative management, which is reserved for lower-demand, medically unwell, elderly patients, (2) surgical osteosynthesis, which remains the treatment of choice for most fractures, and (3) prosthetic replacement with either hemiarthroplasty or total elbow arthroplasty, which is indicated for distal complex comminuted fracture patterns in elderly, low-demand patients with poor bone quality. A thorough understanding of the anatomy around the elbow is critical when planning surgical approach and reduction. Controversies exist in the following areas: (1) surgical approach, (2) management of the ulnar nerve, (3) plating technique—parallel versus orthogonal, and (4) whether osteosynthesis or prosthetic elbow replacement is superior in the elderly population.
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Metadaten
Titel
Management of distal humerus fractures
verfasst von
Alexander Lauder
Marc J. Richard
Publikationsdatum
21.01.2020
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2020
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-020-02626-1

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