861

Anotacoes

861 Fracture of the distal humerus is one of the most challenging injuries that confront the orthopedic traumatologist. Given the relative rarity of these injuries, most surgeons have only limited experience in their manage- ment. 1 Because of the complex regional anatomy, fracture comminution, and limited points for secure fixation, even experienced surgeons find it challenging to achieve stable fixation allowing early return of motion. Injuries of the distal humerus include extracapsular fractures in the supra- condylar region, extraarticular intracapsular (transcondylar) fractures, isolated unicondylar fractures, partial or complete articular fractures, and, most commonly, combined supracondylar-intercondylar fractures. We also address infrequent patterns, which have different demands. GENERAL CONSIDERATIONS IN DISTAL HUMERUS FRACTURES Preoperative Evaluation Fractures of the distal humerus occur in a bimodal age distribution, with distinct patient characteristics. Fractures that occur in physiologically young patients are typically the result of high-energy mechanisms, such as motor vehicle collisions or falls from a significant height. 2 Open wounds, other ipsilateral upper ...