Operative treatment of bicondylar intraarticular fractures of the distal humerus.

Orthopedists' lack of consensus on treatment regimens for bicondylar fractures of the distal humerus warrants further review of this uncommon fracture. We present a series of 17 bicondylar fractures of the distal humerus that had a minimum follow up of 2 years. Of these fractures, the 13 that were treated exclusively with internal fixation had 92% excellent or good results. The operative technique we describe is modified from the technique recommended by the AO group. We have found it helpful to use the radial column as the site of primary fixation with a 3.5 mm dynamic compression plate in the sagittal plane. Additional fixation is provided by a reconstruction plate placed posteriorly on the ulnar column in the coronal plane. This system of dual plates in perpendicular planes provides rigidity for early motion which, when supervised, is beneficial to a satisfactory outcome.