Coronal shear fractures of the distal humerus

Coronal shear fractures of the distal humerus are rare but severe injuries. Especially older patients with low bone density and consecutive comminuted fractures represent many challenges in treatment in order to maintain a satisfactory reconstruction of the elbow joint. Open reduction internal fixation (ORIF) is recommended in the current management of coronal shear fractures to restore articular congruity and initiate early motion, as long as a stable reconstruction can be achieved. However, when stable fixation is not possible, arthroplasty is usually considered the treatment of choice, especially in older patients. This review reflects on the current treatment strategies and their clinical results. A treatment algorithm is also proposed.