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Brian Brighton - One of the best experts on this subject based on the ideXlab platform.
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Transphyseal Distal Humerus Fracture.
Instructional course lectures, 2016Co-Authors: Joshua Abzug, Christine Ann Ho, Todd F Ritzman, Brian BrightonAbstract:Transphyseal Distal Humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal Distal Humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the Humerus on plain radiographs may aid in the diagnosis of a transphyseal Distal Humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar Humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal Distal Humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.
George S. Athwal - One of the best experts on this subject based on the ideXlab platform.
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An anthropometric study of the Distal Humerus
Journal of shoulder and elbow surgery, 2014Co-Authors: Sagar J. Desai, George S. Athwal, Simon R. Deluce, James A. Johnson, Louis M. Ferreira, Alexandre Leclerc, Graham J.w. KingAbstract:Background: The optimal articular shape for Distal humeral hemiarthroplasty has not been defined because of a paucity of data quantifying the morphology of the normal Distal Humerus. This study defines the osseous anatomy and anatomic variability of the Distal Humerus using 3-dimensional imaging techniques. Methods: Three-dimensional surface models were created from computed tomography scans obtained from 50 unpaired human cadaveric elbows. Geometric centers of the capitellum and the trochlear groove defined the anatomic flexion-extension axis. A coordinate system was created, and the Distal Humerus was sectioned into 100 slices along this axis. The C line was defined as the line of best fit connecting the geometric centers of each of the slices. Results: The anatomic flexion-extension axis of the Distal Humerus was found to be an average of 1 � � 1 � from the C line (range, 0 � -3 � ) in the coronal plane and 2 � � 1 � (range, 0 � -7 � ) in the transverse plane. The average trochlear width was 22 � 3 mm, and the average trochlear height was 18 � 2 mm. The mean width of the capitellum was 17 � 2 mm; the height was 23 � 2m m (P < .001). Conclusions: The difference in the capitellum width and height demonstrates that the capitellum is ellipsoid, not spherical. A data bank of humeral dimensions may be used for the development of future Distal humeral hemiarthroplasty implants. A more anatomic implant may optimize kinematics and maximize contact area, thus minimizing contact stresses on the native ulna and radius. Level of evidence: Anatomic Study, Imaging. 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.
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Open Reduction and Internal Fixation of Distal Humerus Fractures
Operative Techniques in Orthopaedics, 2010Co-Authors: Danny P. Goel, Jeffrey M. Pike, George S. AthwalAbstract:Distal Humerus fractures are common and represent 2% of all fractures and approximately 30% of those affecting the Humerus. The management of Distal Humerus fractures is complicated by the complex 3-dimensional anatomy of the elbow, the limited bone stock for internal fixation, and often comminuted and osteopenic nature of the articular segment. Surgical treatment should be conducted in a systematic manner to minimize complications. Using the principles of anatomic articular reconstruction with stable fixation to allow early range to motion, good to satisfactory outcomes can be expected in most patients.
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Prosthetic replacement for Distal Humerus fractures.
Orthopedic Clinics of North America, 2008Co-Authors: George S. Athwal, Thomas J. Goetz, J. Whitcomb Pollock, Kenneth J. FaberAbstract:Primary total elbow arthroplasty is a treatment option for elderly patients with osteopenic bone, increased comminution, and articular fragmentation. Recently, there has been a renewed interest in Distal Humerus hemiarthroplasty for the treatment of Distal Humerus fractures, including coronal shear fractures of the capitellum and trochlea. This article focuses on the evaluation and management of Distal Humerus fractures with prosthetic replacement.
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Distal Humerus fractures.
The Orthopedic clinics of North America, 2008Co-Authors: J. Whitcomb Pollock, Kenneth J. Faber, George S. AthwalAbstract:Intra-articular fractures of the Distal Humerus are among the most challenging fractures to manage. Nonoperative treatment, although appropriate for some patients, often leads to loss of motion and unsatisfactory functional outcomes. Over the last 2 decades, enhanced operative techniques and implant designs have improved the reduction and stability of Distal Humerus fractures leading to better outcomes. Careful preoperative planning, adequate exposure, and stable fixation facilitating early mobilization are essential to achieve successful outcomes with internal fixation.
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Surgical exposures for Distal Humerus fractures: a review.
Clinical anatomy (New York N.Y.), 2008Co-Authors: J. Whitcomb Pollock, George S. Athwal, Scott P. SteinmannAbstract:The majority of Distal Humerus fractures have complex fracture patterns, with displaced articular segments, requiring operative intervention. The goals of surgery are anatomic reduction and rigid internal fixation via an operative approach that balances maximum required exposure with minimum soft tissue or bony disruption that may necessitate postoperative protection. The selection of a surgical approach depends on multiple factors, including, facture pattern, extent of articular involvement, associated soft tissue injury, rehabilitation protocols, and surgeon preference. This review focuses on the various surgical approaches to the Distal Humerus. Clin. Anat. 21:757–768, 2008. © 2008 Wiley-Liss, Inc.
Joshua Abzug - One of the best experts on this subject based on the ideXlab platform.
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Transphyseal Distal Humerus Fracture.
Instructional course lectures, 2016Co-Authors: Joshua Abzug, Christine Ann Ho, Todd F Ritzman, Brian BrightonAbstract:Transphyseal Distal Humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal Distal Humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the Humerus on plain radiographs may aid in the diagnosis of a transphyseal Distal Humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar Humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal Distal Humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.
Christine Ann Ho - One of the best experts on this subject based on the ideXlab platform.
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Transphyseal Distal Humerus Fracture.
Instructional course lectures, 2016Co-Authors: Joshua Abzug, Christine Ann Ho, Todd F Ritzman, Brian BrightonAbstract:Transphyseal Distal Humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal Distal Humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the Humerus on plain radiographs may aid in the diagnosis of a transphyseal Distal Humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar Humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal Distal Humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.
Todd F Ritzman - One of the best experts on this subject based on the ideXlab platform.
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Transphyseal Distal Humerus Fracture.
Instructional course lectures, 2016Co-Authors: Joshua Abzug, Christine Ann Ho, Todd F Ritzman, Brian BrightonAbstract:Transphyseal Distal Humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal Distal Humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the Humerus on plain radiographs may aid in the diagnosis of a transphyseal Distal Humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar Humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal Distal Humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.