The Orthobullets Podcast

Podiums | Trauma | Fixing the Distal Humerus with the Triceps On

Nov 5, 2025
Guest
Jack Kazanjian DO
Dr. Jack Kazanjian, an expert in complex elbow surgeries, shares insights on fixing distal humerus fractures. He discusses the advantages of the triceps-on approach, emphasizing its benefits over traditional techniques like olecranon osteotomy. Hear about essential surgical tips, the importance of preoperative planning, and how maintaining native anatomy can improve outcomes. Through clinical cases, Jack illustrates intraoperative techniques and shares his final recommendations for effective fixation. His approach might be challenging but promises significant rewards!
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INSIGHT

Plan With 3D CT For Better Fixation

  • Distal humerus fractures are complex and usually need surgery to preserve the joint.
  • CT with 3D reconstructions is essential for preoperative planning and implant selection.
ADVICE

Prefer Triceps-Sparing When Feasible

  • Decide between triceps-sparing (paratricipital) and olecranon osteotomy approaches based on exposure needs.
  • Avoid osteotomy when possible due to added complications, time, and cost.
ADVICE

Expose Joint With The Triceps-On Technique

  • Use the triceps-on (paratricipital) approach with careful lateral dissection to gain joint exposure.
  • Position prone with the arm on a Mayo stand and use patience to obtain reduction and fixation.
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