A 19-year-old female fell while bicycling at a high speed and sustained an open fracture (Grade IIIA) of the distal humerus and presented through our affiliated Emergency Department at NewYork-Presbyterian Hospital and she was placed under the care of
Dr. David L. Helfet. Radiographs revealed a left-sided complex bicondylar distal humerus fracture with segmental bone loss. Following multiple Irrigation and Debridement (I&D) procedures a spanning external fixator was placed for initial stabilization and a skin graft was also placed. Operative reduction and internal fixation (ORIF) was performed at 2 weeks following her injury with placement of bone graft and multiple plates and screws. She returned for regular follow-up visits and had an excellent outcome. At 25 months postoperative her radiographs reveal a healed distal humerus fracture and clinically she had no pain with range of motion of the left elbow from 0 to 110° with full supination and pronation.
Anteroposterior and lateral x-rays revealing a left-sided bicondylar distal humerus fracture (2 left images);
x-rays following placement of a spanning external fixator (2 right images).
Pre-operative plan (left image) for placement of bone graft and plate and screw fixation placed in
a 90/90 fashion; x-rays at 25 months (2 middle images) illustrating a healed distal humerus fracture;
clinical images at 25 months (images on top-right and top-bottom) and illustrating excellent range of motion.
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