• INTRODUCTION
    • Unicondylar distal humeral fractures are uncommon, partially intra-articular fractures (OTA/AO type B1) that are among the most complex fractures to treat1,2; however, most displaced distal humeral fractures, including lateral unicondylar distal humeral fractures2-5, can be effectively managed with open reduction and internal fixation.
  • STEP 1 PREPARATION OF THE OPERATING ROOM AND THE PATIENT
    • Perform sterile preparation, have the patient brought into the operating room, induce anesthesia, and place the patient in the lateral decubitus or supine position before sterile draping.
  • STEP 2 APPROACH TO THE FRACTURE
    • Make a lateral incision, expose the lateral distal part of the humerus, identify the ulnar nerve if necessary, visualize the fracture fragments, and debride the fracture site.
  • STEP 3 REDUCTION OF THE FRACTURE
    • Reduce the fracture and fix it temporarily.
  • STEP 4 PLATE FIXATION OF THE FRACTURE
    • Determine the plate length; position the plate posterolaterally, posteriorly, or laterally; insert screws; remove provisional Kirschner wires; and obtain intraoperative images.
  • STEP 5 FINAL RADIOGRAPHIC IMAGING
    • Make anteroposterior and lateral radiographic images to confirm reduction and adequate anatomic alignment of the elbow and the position of the hardware.
  • STEP 6 CLOSURE OF THE WOUND
    • Deflate the tourniquet, irrigate the wound, and apply postoperative dressings.
  • RESULTS
    • The detailed outcome for a cohort of 24 patients who underwent this procedure has been reported elsewhere6.