Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table with the affected arm draped across the chest to allow for optimal access to the humerus.

Anatomical surgical approach:  A posterior approach to the elbow was utilized, involving an olecranon osteotomy to gain access to the distal humerus. Capsular release and scar takedown were performed to address arthrofibrosis. Careful mobilization of the ulnar nerve was conducted to prevent damage during exposure and fixation.

The surgeon emphasized the importance of recognizing the complex articular nature of the injury, which necessitated a detailed approach to achieve anatomic reduction of the joint. The diaphyseal fracture was managed with bridge plating, ensuring relative stability through long plates with low screw density to promote callus formation. The indirect reduction technique preserved the biological environment of the diaphyseal fragments.

Postoperative protocol:   Postoperatively, a soft dressing was applied, and early active and passive motion were encouraged to promote joint mobility and prevent stiffness.

Follow up:   Not specified.

Orthopaedic implants used:   Long bridge plates with low screw density for relative stability.