Fractures of the Distal Humerus

Abstract

As our population ages fractures of the distal humerus will become increasingly common, with a nearly threefold increase projected by the year 2030 [1]. The major determinant in this expected rise in fracture rates is a corresponding increase in the number of patients with osteoporosis. The treatment of the osteoporotic distal humerus fracture has traditionally posed great difficulty and surgical results have often been disappointing [2–6]. However, with the advent of newer fixation techniques and evolving treatment modalities, the initial despair with which these injuries were viewed has given way to a more optimistic outlook. Significant osteoporosis is no longer considered a contraindication to aggressive surgical stabilization and good results can be obtained even in the severely osteopenic patient [7–14]. The liberal use of bone graft, multiple plate and screw fixation techniques, and the use of methylmethacrylate for enhanced screw fixation have all been important developments in the treatment of these fractures. Furthermore, total elbow arthroplasty provides us with a salvage procedure for those rare injuries that are not amenable to operative reconstruction. It is imperative that the treating physician has a thorough understanding of modern surgical principles and techniques in order to treat fractures of the osteoporotic distal humerus effectively.