REVIEW ARTICLE


Challenges and Solutions in Management of Distal Humerus Fractures



Saif Ul Islam*, Alexander William Glover, Mohammad Waseem
Macclesfield District General Hospital, Cheshire, United Kingdom


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© 2017 Ul Islam et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Macclesfield General Hospital, Victoria Road, Macclesfield, Cheshire, SK10 3BL, United Kingdom; Tel: 00441625661315; E-mail: dr_saifulislam@hotmail.com


Abstract

Background:

Management of distal humerus fractures remains a challenge for trauma surgeons and advancements in treatment options continue to be made to achieve the best results for patients presenting with these complex fractures. Our aim in this article is to provide the surgeons with a detailed review of current literature to help them make an evidence based decision when faced with managing such complex injuries in their surgical practice.

Methods:

This is a comprehensive review of the current literature that details various aspects of distal distal humerus fractures such as classification, surgical anatomy, surgical approaches, treatment options, choices of devices, outcomes and complications.

Results:

With the advancements in techniques and equipment, there has been improvement in patients’ outcomes following surgical management of these fractures and a large proportion of these patients are able to achieve pre-injury level of function. The contoured locking plates have enabled successful fixation of many of these fractures that were previously considered unfixable. For those not amenable to surgical fixation, total elbow arthroplasty and elbow hemiarthroplasty are considered as good alternatives.

Conclusion:

Since the days where the ‘bag of bones’ technique was the preferred method of treating these complex injuries, techniques and outcomes have advanced greatly. However, they still present a significant technical challenge and need meticulous technique and experience to achieve optimal results.

Keywords: Humerus, Elbow, Humerus fractures, Elbow approaches, Total elbow replacement, Distal humerus plates.