- Discussion:
- condyles will frx apart w/ variable amount of displacement, & comminution;
- Approach:
- use posterior approach w/ olecranon osteotomy;
- articular surface is restored using interfragmentary lag screw fixation;
- coronoid and olecranon fossa must not be violated with fixation, nor should width of the trochlea be narrowed by overcompressing the
condyles;
- condyles are then stabilized to humeral shaft w/ medial & lateral plates.
- consider ulnar nerve transposition;
- Multifragmentary intra articular fractures:
- posterior approach:
- identify the ulnar nerve
- osteotomy of the olecranon;
- exposure of the fracture;
- reconstruction of the joint using K wires, or 1.6 mm threaded guide wires if 4.5 mm canulated screw over the threaded guide wire;
- defects of the articular surface: 3.5 mm cortex screws as fixation screws in combination with bone grafting;
- 5 to 7 hole 3.5 mm reconstruction plate is applied to dorsolateral side;
- on medial may use a reconstruction plate or one third tubular plate;
- reattachment of the olecranon
Intercondylar fractures of the humerus. An operative approach.