Secondary Procedures and Surgical Treatment of Distal Humerus Fractures

Every surgeon treating distal humeral fractures understands that perfection is usually an unobtainable goal. Sound surgical treatment with modern implants does usually render a functional and painless elbow, but complications do occur in properly treated distal humeral fractures. Fixation can fail, articular cartilage can be damaged beyond its ability to heal, and non-unions occur for mechanical and biological reasons. Understanding indications for revising distal humeral fracture treatment requires knowledge of extensile exposures to the elbow and current implant technology. Distal humeral articular surfaces that can not be reconstructed can now be partially or totally resurfaced, obviating the need for a salvage with a total elbow implant. Some distal humeral revisions are best treated with a linked total elbow implant. When considering revising a distal humeral fracture fixation, it is imperative to align patient and surgeon expectations and ensure both parties understand what potential complications can occur during any revision.