Current management of distal humerus fractures

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Purpose of review

The purpose of this article is to review the management of distal humerus fractures as well as to discuss several of the controversies which exist when treating this dreadful injury.

Recent findings

The most current outcome studies of periarticular distal humerus fractures have shown improvements in patient function and satisfaction compared with a decade ago. Recent literature has questioned the utility of orthogonal plating and has offered the recommendation of ‘parallel’ plating. Further, although open reduction internal fixation of distal humerus fractures in the elderly has had success, total elbow replacement seems to have more predictable results at short-term follow-up in this patient population.


As with all periarticular fractures, the most important key in achieving a good outcome is an immediate postoperative range of motion. This is obtained by anatomic restoration of the joint surface, secure fixation and adequate joint–shaft alignment and immediate maintenance of a functional arc of motion.

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