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J Am Acad Orthop Surg, Vol 18, No 1, January 2010, 20-30.
© 2010 the American Academy of Orthopaedic Surgeons
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Current Treatment Strategies for Bicolumnar Distal Humerus Fractures

Gregory J. Galano, MD, Christopher S. Ahmad, MD and William N. Levine, MD

From the Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY.

Dr. Ahmad or an immediate family member has received research or institutional support from Acumed, Arthrex, and Zimmer. Dr. Levine or an immediate family member serves as a paid consultant to or is an employee of Acumed and Serica and has received research or institutional support from Arthrex, Zimmer, and Smith & Nephew. Neither Dr. Galano nor any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Management of distal humerus fractures continues to challenge orthopaedic surgeons. The unique and complex anatomy of the distal humerus, involving the ulnohumeral and radiocapitellar joints, makes anatomic reduction difficult and hardware placement challenging. However, long-term results of well-performed open reduction and internal fixation demonstrate satisfactory outcomes in most patients. Osteoporosis in the elderly population often leads to severe comminution, which may render open reduction and internal fixation impossible. Total elbow arthroplasty in the elderly has become a viable option, with excellent results in the properly selected patient who understands the lifetime limitations of this option. Distal humeral replacement is a new and potentially exciting option but it is currently not approved by the US Food and Drug Administration and has no long-term follow-up to support its use.






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Copyright © 2010 by the American Academy of Orthopaedic Surgeons.