Review Question - QID 6453

The most common complications associated with open reduction and internal fixation of distal humerus fractures are those associated with repair of an associated olecranon osteotomy. Complications associated with olecranon osteotomy fixation include failure of fixation (5%) and the need for secondary removal of painful hardware (70%). Nonunion of a distal humerus fracture treated with 90/90 plating is uncommon and results from inadequate fixation, excessive soft-tissue stripping, or use of inadequate plate fixation such as one third tubular plates. Heterotopic ossification is seen in approximately 4% of cases, infection 4%, and ulnar nerve palsy 7%. Although a relatively minor complication, the need for removal of painful hardware from the olecranon osteotomy is by far the most common complication seen in these cases.