Elbow fractures

A 19-year-old female fell while bicycling at a high speed and sustained an open fracture (Grade IIIA) of the distal humerus and presented through the New York Presbyterian Emergency Department.

Radiographs revealed a left-sided complex bicondylar distal humerus fracture with segmental bone loss. Following multiple Irrigation and Debridement (I&D) procedures a spanning external fixator was placed for initial stabilization and a skin graft was also placed.

Operative reduction and internal fixation (ORIF) was performed at 2 weeks following her injury with placement of bone graft and multiple plates and screws. She returned for regular follow-up visits and had an excellent outcome.

At 25 months post-operative her radiographs reveal a healed distal humerus fracture and clinically she had no pain with range of motion of the left elbow from 0 to 110° with full supination and pronation.

Figure A

Anteroposterior (AP) and lateral x-rays revealing a left-sided bicondylar distal humerus fracture.

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Figure B

X-Rays following placement of a spanning external fixator.

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Figure C

Pre-operative plan for placement of bone graft and plate and screw fixation placed in a 90/90 fashion.

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Figure D

X-Rays at 25 months illustrating a healed distal humerus fracture.

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Figure E

Clinical images at 25 months illustrating excellent range of motion.

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Tags: Elbow Fracture, Humerus Fracture

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David L. Helfet, MD

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