Posterior approaches for articular distal humeral fractures

Approaching the elbow joint posteriorly is the most used method to visualize closed fractures of the distal humerus in adults. Treatment can span from open reduction and internal fixation to elbow hemiarthroplasty and total elbow arthroplasty. Different approaches were developed in the necessity of balancing an adequate visualization with minimizing complications and these surgical exposures can be divided into four main categories: paratricipital, triceps reflecting, triceps splitting and olecranon osteotomy. In this article are described the positive and negative features of the principal posterior elbow approaches and their best clinical uses for the treatment of distal humerus complete articular fractures classified according to AO/OTA classification 13C.