Minimally Invasive Methods for Adolescent Intraarticular Distal Humerus Fractures with an Intact Column.

UNLABELLED

Intraarticular distal humerus fractures can occur in adolescents and represent a unique morphology that is amenable to different surgical techniques than distal humerus fractures in adults or younger children, especially when one column remains intact. Despite articular involvement, a minimally invasive approach utilizing the intact periosteum and opposing intact column of bone can often achieve successful reduction and fixation. Here, we present operative techniques that we have found helpful for these fractures.

KEY CONCEPTS

•Intraarticular distal humerus fractures occur in adolescents and often demonstrate a characteristic pattern with a relatively vertical intraarticular fracture line with minimal articular comminution and limited displacement.•Excellent reduction and fixation can often be accomplished through minimally invasive or percutaneous techniques, unlike most intraarticular distal humerus fractures in adults.•In this paper, we describe straightforward fracture reduction methods, including indirect reduction via guide pins and cannulated screws alone or augmented with a periarticular clamp or ball-spike pusher.•Our preferred fixation technique involves lateral-to-medial screws, ideally with one screw just proximal to the articular surface and additional screws as needed proximal to the olecranon fossa.