Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table with the affected arm draped free to allow access to both the humeral shaft and the elbow joint.

Anatomical surgical approach:  A posterior approach to the humerus was utilized for fracture fixation. The lateral approach to the elbow involved exposure of the lateral collateral ligament complex for repair, specifically targeting the lateral ulnar collateral ligament (LUCL) with suture anchors.

The surgeon noted technical challenges during the operation, particularly with the placement of the suture anchor for the LUCL repair, which was not in the ideal isometric location. Additionally, despite efforts to preload and compress the plate on the humerus, an extension deformity resulted post-fixation. The decision was made not to revise this deformity as it was not anticipated to cause functional deficits or healing complications.

Postoperative protocol:   Postoperative rehabilitation included early active motion of the elbow to prevent stiffness, with gradual progression to weight-bearing activities as tolerated by the patient.

Follow up:   Not specified.

Orthopaedic implants used:   Suture anchors for LUCL repair, compression plate for humeral shaft fixation.