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Fig. 1

(A) Anterior, (B) posterior view of column structure of the distal humerus.

Fig. 2

Alignment of medial and lateral side of the distal humerus.

Fig. 3

Illustrations show AO classification 13 C1, C2, C3.

Fig. 4

Bare area marked with arrow does not have articular cartilage, so bare area is in the osteotomy.

Fig. 5

When hinge-opening the periarticular bone fragment (arrow) from side to side to find a coronal fragment shown in computed tomography and fix it.

Fig. 6

A 3D computed tomography which displays a coronal bone fragment invading the front of trochlea (arrow). A clinical picture showing a coronal bone block fixed with a 0.9 mm K-wire. K-wire is buried in the bone, when reducing captellum and trochlea after sticking it to the fractured side and cutting it. There is an embedded K-wire to fix the coronal bone fragment in the picture taken after the surgery (arrow).

Fig. 7

An example of an accurate operation of tension band wiring and plate fixation using a transosseous pin.

Fig. 8

When K-wire is too deeply inserted into the bone without accurate reduction and compression of osteotomy part right after the surgery. Especially, inserting two k-wires into the lateral side may restrict joint movement, by causing a collision in the radial tuberosity, because they protrude too much as shown in the oblique view. Therefore, it requires a careful attention. There was an early loss of fixation as displayed in the picture taken a month later the surgery. This could be solved with plate fixation.

Fig. 9

When reducing AO 13 C2 fracture with the side to side retraction approach and fixing it. It was found that there was no articular comminution or coronal bone fragment in the computed tomography, and it was possible to reduce the joint without osteotomy of olecranon, because it was separated between trochlea and capitellum.

Fig. 10

A clinical image to fix a plate in the medial and posterolateral side and a radiograph which shows accurate joint reduction and joint movement during the surgery.

Fig. 11

Conventional orthogonal plating with congruent elbow plating system.

Fig. 12

Anatomical precontoured locking compression plate with congruent elbow plating system.

Fig. 13

When inserting a screw through a screw hole of plate after reducing the periarticular bone fragment with pointed reduction forceps and fixing it rather than a separate lag screw.

Fig. 14

An example of fixation in a small metaphyseal wedged-bone fragment using 2.7 mm / 2.0 mm screws.

Fig. 15

Parallel plating with congruent elbow plating system.

Fig. 16

A case to fix C2 fracture accompanied by a low lateral column fracture (arrow) successfully with parallel plating.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by  

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  Chul-Hyung Lee, Doo-Hun Sun, Deukhee Jung, Chung-Han An
  Journal of the Korean Fracture Society.2019; 32(3): 128.     CrossRef
• How Difficult Is It to Surgically Treat AO-C Type Distal Humerus Fractures for Inexperienced Orthopedic Surgeons?
  Seong Ho Yoo, Suk Woong Kang, Moo Ho Song, Young Jun Kim, Hyuck Bae
  Journal of the Korean Fracture Society.2018; 31(2): 45.     CrossRef