• Giovanni Vicenti, Davide Bizzoca, Domenico Zaccari, Claudio Buono, Arianna Carlet, Giuseppe Solarino, Riccardo Giorgino, Emmanuele Santolini, Enricomaria Lunini, Giacomo Zavattini, Guglielmo Ottaviani, Massimiliano Carrozzo, Filippo Simone, Alessandro Marinelli, Roberto Rotini, Andrea Franchini, and Biagio Moretti.
• School of Medicine, University of Bari Aldo Moro, AOU Consorziale "Policlinico", Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, Bari, Italy.
• Injury. 2023 Mar 1; 54 Suppl 1: S78S84S78-S84.

IntroductionCoronal shear fractures of the distal humerus are uncommon injuries representing 6% of distal humeral fractures. There is no univocal consensus about the correct management of this type of fracture. A national survey was conducted to gain more insight into the current classification, diagnosis and treatment of coronal shear fractures in Italy.Materials And MethodsA postal survey was sent to all AO Italian members including residency orthopaedic surgeons. The survey consisted of general questions about personal experience in the management of these fractures: types of classification systems used, surgical approaches, treatment options and rehabilitation programs.Results114 orthopaedic surgeons answered a 13-items questionnaire. The most used classification system was AO/OTA (72,8%). Independent screws and if necessary plates were the most answered regarding surgical treatment (81,6%). The most encountered post-surgical complication was stiffening of the elbow (81,6%).ConclusionAn algorithm of treatment has been proposed. To better classify coronal shear fractures, the authors recommended the integration of two classification systems: AO and Dubberley classifications. In the case of posterior wall comminution, a Kocher extensile approach is recommended, otherwise, if a posterior wall is intact, Kocher or Kaplan approach can be used. The posterior transolecranic approach can be reserved to Dubberley type III or AO 13B3.3. The best treatment choice is represented by independent screws and plates placed according to fracture patterns while arthroplasty is indicated when a stable ORIF is not possible. Mobilization is postponed for about 2 weeks.Copyright © 2022. Published by Elsevier Ltd.

9 keywords...

hide…