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Total elbow arthroplasty
2%
12/687
Closed reduction and casting
0%
0/687
Open reduction and internal fixation of both the radial head and distal humerus
95%
651/687
Open reduction and internal fixation of the radial head and excisional arthroplasty of the distal humerus
Hinged external fixation with associated ligamentous reconstruction
1%
7/687
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This injury represents a complex partial articular fracture of the distal end of the humerus with an associated radial head fracture. Given this patient's young age, partial or complete arthroplasty is not an option. Closed reduction will lead to poor elbow function. Ligamentous repair is not indicated and external fixation will not aid in articular reduction. The patient requires open reduction and internal fixation of both components of the intra-articular injury. This is best accomplished through an extensile lateral approach or an olecranon osteotomy. Headless screws are preferred for articular reconstruction in these cases.
3.9
(9)
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