Bicondylar intraarticular fractures of the distal humerus in adults

Bicondylar intraarticular fractures of the distal humerus, because of their rarity and often associated significant displacement, comminution, and osteopenia, present the orthopedist with a difficult injury to reliably treat successfully. As with any displaced intraarticular fracture, the principles of anatomic restoration of the articular surface, stable fixation, and early motion are the optimal treatment goals. To obtain reproducible results, an established treatment protocol is required and is described in detail here. The average excellent-to-good results with surgical treatment for Type C fractures ("T" or "Y" bicondylar fractures) is 75% (range, 65-100%). Complications include heterotopic ossification (4%), infection (4%), ulnar nerve palsy (7%), failure of fixation (5%), and non-union (2%).