Description
In this presentation by Andrew Wright, the discussion revolves around distal humeral fractures, highlighting their heterogeneous nature and the different classification types, specifically the A0 classification used to categorize these injuries. The talk emphasizes the distinction between extra-articular, partial articular, and intra-articular fractures, detailing the various approaches for surgical intervention based on fracture complexity. A significant focus is placed on the surgical setup in the operating room, advocating for a tourniquet-free approach and the use of a standard setup that supports the patient effectively. Wright explores several posterior approaches, including the importance of incision technique—favoring straight over curved incisions to optimize access and reduce complications. The presentation reviews historical and modern approaches to accessing the distal humerus, including the Campbell approach, the Alonso Llames method, and the newer lateral paraolecranon approach, comparing their effectiveness and visualization capabilities. Attention is given to nerve preservation, particularly the ulnar and radial nerves, during surgical intervention. Additionally, the classification of partial articular fractures is discussed, offering a framework for surgical management using a modified Dubberley classification. The talk concludes with practical advice on mapping these fractures via 3D imaging and preoperative planning to improve outcomes.
DOI: 10.1302/3114-230112