Optimising Outcomes in Fracture Distal Humerus

Description

In this detailed lecture presented by Professor Bijayendra Singh, an experienced orthopedic surgeon, attendees gain insights into the management of distal humerus fractures, especially in terms of improving fixation outcomes. The talk begins with an introduction of the speaker's credentials and the focus of the presentation, which deliberately excludes discussions on arthroplasty and unrelated injuries.



Professor Singh shares a clinical case of a 35-year-old male patient who suffered a fall and sustained a humeral fracture, thereby highlighting the importance of understanding fracture anatomy and treatment approaches. Throughout the session, he focuses on key areas including fracture patterns, surgical approaches, and fixation techniques, emphasizing the lessons learned from past failures to enhance learning.



He explains crucial anatomical details of the distal humerus, discussing its two columns and joint functionality that must be restored for optimal recovery. He elaborates on necessary imaging techniques, such as CT scans, that aid in assessing the extent of injuries and the importance of precise surgical approaches tailored to each fracture pattern.



Professor Singh provides specific details on the fixation methodology for different types of fractures—including the use of locking plates and the debated 90/90 and parallel plating techniques. He illustrates his points with examples and explains how he incorporates the principles of stable fixation, encouraging early motion post-surgery.



Diving into complications, he underscores common pitfalls associated with different fixation techniques and emphasizes understanding the patient’s overall health, such as risks associated with age and pre-existing conditions. The presentation concludes with a summary of key takeaways for practice, including the critical considerations for surgical approaches, the handling of soft tissues around nerves, and the necessity to address metaphyseal comminution for successful outcomes.

Specialties