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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Bones of the Upper Limb: Humerus01:19

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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Related Experiment Video

Updated: Jan 14, 2026

Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
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The Unreconstructable Distal Humerus Fracture: Options and Bail Outs in Complex Articular Fractures.

Jason A Strelzow1

  • 1Department of Orthopaedic Surgery, Washington University of St. Louis, 660 South Euclid Avenue Campus Box 8233, St Louis, MO 63110, USA.

Hand Clinics
|October 17, 2025
PubMed
Summary

Distal humerus fractures present complex challenges. Modern fixation improves outcomes, but significant bone loss or comminution may necessitate grafting, fusion, or arthroplasty for successful treatment.

Keywords:
Complex articular fracturesDistal humerusElbowFractureFusionIntra-articularSalvageUnreconstructible

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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Biomedical Engineering

Background:

  • Distal humerus fractures are complex due to intricate 3D anatomy and surrounding soft tissues.
  • Modern fixation techniques have significantly advanced the treatment of these challenging injuries.
  • Despite progress, severe bone loss and articular comminution remain significant treatment hurdles.

Purpose of the Study:

  • To review current management strategies for distal humerus fractures.
  • To highlight the role of advanced fixation principles.
  • To discuss alternative and adjunctive treatments for complex cases with bone loss or comminution.

Main Methods:

  • Review of modern fixation principles for distal humerus fractures.
  • Analysis of adjunctive techniques including bone grafting, fusion, hemi-arthroplasty, and total elbow arthroplasty.
  • Evaluation of outcomes in previously unreconstructible fracture patterns.

Main Results:

  • Advanced fixation allows for improved outcomes in complex distal humerus fractures.
  • Bone loss and articular comminution often require strategies beyond primary fixation.
  • Grafting, fusion, and arthroplasty provide viable options for reconstruction in challenging scenarios.

Conclusions:

  • Modern fixation has expanded treatment possibilities for distal humerus fractures.
  • Management of severe bone loss and comminution necessitates consideration of reconstructive options.
  • Arthroplasty and grafting represent important adjunctive or alternative strategies for complex distal humerus fractures.