Transcondylar fractures of the distal humerus

We classify transcondylar fractures of the distal humerus into four groups: undisplaced; simple displaced; T-type; and fracture dislocations (Posada's fracture). Our treatment of these fractures is based upon this classification. Undisplaced fractures are treated with immobilization. Displaced fractures are reduced and stabilized with internal fixation. Stabilization of these fractures is difficult because the distal fragments are small and a large portion of their surface is covered with articular cartilage. Transposition of the ulnar nerve allows us to use the cubital tunnel as a point for fixation. We found in our series of 11 patients that undisplaced fractures have the best prognosis. However, all of our patients lost elbow motion, particularly extension. Radiographic signs of post-traumatic arthritis were more pronounced in displaced fractures.