Related Experiment Video
Updated: Mar 30, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Condylar orientation plating in comminuted intraarticular fractures of adult distal humerus
Sukhendu Sarkhel1, Sailendra Bhattacharyya1, Somnath Mukherjee1
1Department of Orthopaedics, Bhattacharyya Orthopaedics and Related Research Centre, Narayanpur, P.O.; R-Gopalpur, Kolkata, India.
Background:
The condyles of the distal humerus have characteristic orientation in reference to the diaphysis. Anatomical reduction of the articular surface in intraarticular fractures of adult distal humerus does not always restore preinjury functional status. The purpose of this study was to determine the outcome of treating these fractures with technique of condylar orientation precontoured plating. The principle of the technique is to primarily restore the anatomical orientation of the reconstructed distal humeral condyle with the diaphysis of the humerus apart from anatomical reduction of fracture.
Materials And Methods:
Seventy one consecutive patients with comminuted intraarticular adult distal humerus fractures were treated with the condylar orientation plates, which were specifically designed between 1999 and 2009. 43 fractures were Association for osteosynthesis (AO) type C3, 24 were C2 and 4 were C1. Six were open cases and two were of nonunion distal end humerus. On medial and posterolateral side of the distal humerus, precontoured Sherman plates were applied. Patients were followed up for a mean of 3 years. They were assessed clinically (using mayo elbow performance score [MEPS]) and radio-graphically.
Results:
Sixty (84.5%) patients regained MEPS of 90 or more that is an excellent result (range of movement and functional status). One patient had nonunion with implant failure, and two patients developed heterotopic ossification. The mean MEPS was 95. Average extension and flexion was 15° and 133°. The result was graded as excellent in 60, good in 7, fair in 3 and poor in 1. At the time of most recent followup, 63 elbows were painless, and eight had mild pain.
Conclusion:
Excellent pain free range of motion with a high rate of union can be achieved in comminuted intraarticular distal humerus fractures in adults with the use of condylar orientation precontoured plating technique. Condylar orientation is very important with perfect articular congruity in elbow motion.
Related Concept Videos
01:19Bones of the Upper Limb: Humerus
01:15Bones of the Upper Limb: Ulna
01:09Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An...
01:09Bones of the Upper Limb: Radius
The radius has a nail-shaped head, and a...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...