The Orthobullets Podcast Podiums | Trauma | Treatment for Unreconstructable Distal Humerus Fractures
Nov 6, 2025
Join orthopedic surgeon H. Brent Bamberger, a leading expert in elbow trauma, as he delves into the intricacies of treating unreconstructable distal humerus fractures. He highlights the critical functional role of the elbow and discusses innovative treatment algorithms. Bamberger challenges age-based treatment approaches and offers insights into hemiarthroplasty versus total elbow arthroplasty, reviewing real-world outcomes and complications. He provides practical tips for surgical techniques and emphasizes the importance of tailored patient care.
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Columnar Stability Over Compression
- The distal humerus functions by fixing the medial and lateral columns and placing a stable spool at the end for motion.
- Restoring columnar stability is more critical than perfect articular compression for elbow function.
94-Year-Old Case That Shaped Practice
- Dr. Bamberger recounted a 94-year-old patient who received a total elbow but later required a large allograft and lived to 100.
- He reflected that age-based bias led him to choose a total when fixation might have been preferable.
Use K-Wires As Fixed-Angle Supports
- Use thin K-wires as fixed-angle supports under plates for severely comminuted distal humerus fragments.
- Bend and lock the wires to the plate to achieve stability and allow early motion while fragments heal.
