Right shoulder and arm, posterior view
Medial aspect of right forearm
Blood supply and anastomosis around the right elbow. Anterior view
The triangular structure of distal humerus at elbow joint provides structural strength.
Anterior view right distal humerus bone
The elbow joint is a hinge joint with axis of rotation around throchlear axis
The mechanism is an axial compression with varying elbow ROM. Flexed elbow < 90° usually results in a transcolumnar fracture while > 90° result in an intercondylar fracture pattern.
Milch Ⅰ: fracture line lateral to capitello-trochlear groove
Milch Ⅱ: fracture passes through the capitello-trochlear groove, unstable elbow
Hinged elbow external fixator
Total joint replacement a consideration for elderly patients with significant comminuted fractures.
Posterior approach to right distal humerus, Radial nerve at risk
Radial nerve is responsible for motor elbow and wrist extension. Sensory distribution shown on pic.
Distal humerus to curving around the lateral olecranon to 2-4cm along ulnar crest
Hinged external fixator can supplement unstable elbow fracture ORIF and ligament repair.
Arc for safe zone for application of external fixator pins of right arm
Hand grip exercises with arm in splint