This document discusses distal humerus fractures and elbow dislocations. It begins with anatomy of the elbow joint and then describes the classification, clinical features, radiology, treatment and complications of distal humerus fractures. These fractures have two peak incidence ages and can be classified descriptively or using classification systems like Mehne and Matta. Treatment depends on factors like displacement and can include closed reduction, open reduction and internal fixation. Complications include arthritis, loss of motion, and nonunion. Elbow dislocations are also covered, including mechanisms of injury, associated fractures, treatment methods like closed versus open reduction, and potential complications.
11. DISTAL HUMERUS FRACTURE
They have a bimodal age distribution peak
incidences occurring between the ages of 12 to
19 years, usually in males,
Those aged 80 years and older, characteristically
in females
The most common fracture pattern was an extra-
articular fracture accounting for just under 40% of
all fractures.
Bicolumn or complete intra-articular fractures
were the second most common, accounting for
37%.
13. CLINICAL EXAMINATION
Abrasions, bruising, swelling, fracture blisters,
skin tenting, and open wounds
Neurological exam must be performed
Vascular injuries, although rare in distal
humerus fractures, should be assessed by
examining the distal pulses, skin turgor, capillary
refill, and color
Compartment syndrome of the forearm
26. Non operative treatment
Indications
Nondisplaced fractures
Fracture with sever comminution in elderl
patient
Options available
Cast immobilisation
Bag and bones technique
27. Operative treatment
Indications
Displaced fractures
Comminuted fractures in young patient
Methods available
Interfragmentary screws
Dual plate fixation
Total elbow arthroplasty
28.
29. Complications
Posttraumatic arthritis
Failure of fixation
Loss of motion - Extension
Heterotopic ossification
Neurologic injury - Ulnar nerve
Nonunion of osteotomy
Infection
Deformity
30. ELBOW DISLOCATION
Accounts for 11% to 28% of injuries to elbow
Posterior dislocation common
Simple dislocations are associated with ligamentous
failure
Complex dislocations are associated with fractures
Highest incidence in 10-20 years age
Recurrent dislocations are rare
31. Mechanism of injury
Fall on
outstretched
hand or elbow
Capsuloligame
ntous injury
progresses
from lateral to
medial – Hori
cycle
37. Treatment
Principles
Restoration of bony stability is the goal
Restoration of trochlear notch of ulna
Radiocapitellar contact
Lateral collateral ligament is more
important than medial collateral ligament for
the stability
38. Nonoperative
Closed reduction under sedation
followed by above elbow splint for 2 weeks
Elbow rehabilitation after 2weeks
Methods of closed redution
1.Parvins method
2.Meyn and Quigleys method