Abstract
Proximal fractures of the humerus are at high risk of osteonecrosis if the medial
calcar is disrupted and the metaphyseal extension of the head fragment is <8mm. Risk
factors for failure of osteosynthesis include: poor bone stock, varus dislocation,
head dislocation and medial comminution.
During surgical treatment of distal humerus fractures, one should aim to restore the
arc and stabilize the columns. Several technical rules have been outlined by O´Driscoll
and are mentioned in this article in detail.
In fractures of the distal radius, the length, the joint surface, and joint angles
(palmar inclination ca. 11°, radial inclination ca. 22°) should be reconstructed.
Several surgical factors are associated with the development of radiocarpal osteoarthritis
including the sagittal depth of the articular cavity and the anterior-posterior diameter
of the fossa lunata of the distal radius.
When managing fractures of the proximal tibia, a four- or more column classification
system should be used to plan the surgical steps and choose the appropriate approach(es).
In ankle fractures, intraoperative 3-D-Scan should be considered especially in the
case of syndesmotic involvement or involvement of the posterior malleolus.
Keywords
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Article info
Publication history
Published online: May 19, 2022
Accepted:
May 8,
2022
Footnotes
Level of evidence, IV.
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
