Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature

Articular fractures of the distal humerus are rare, and even rarer are fractures involving the trochlea and capitellum in a single fragment, with no associated comminution. These fractures are classified as 2a according to the Dubberley classification and are rarely described in the literature. Two...

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Main Authors: Raphaël Fouché, Laela El Amiri, Nassim Bestandji, André-Pierre Uzel
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644024000554
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author Raphaël Fouché
Laela El Amiri
Nassim Bestandji
André-Pierre Uzel
author_facet Raphaël Fouché
Laela El Amiri
Nassim Bestandji
André-Pierre Uzel
author_sort Raphaël Fouché
collection DOAJ
description Articular fractures of the distal humerus are rare, and even rarer are fractures involving the trochlea and capitellum in a single fragment, with no associated comminution. These fractures are classified as 2a according to the Dubberley classification and are rarely described in the literature. Two cases of Dubberley 2a fractures were treated at our hospital. The first case, involving a 68-year-old patient, was treated with a medial and a lateral approach, combined with posteroanterior fixation using 3 Herbert screws. In the 2nd case, a 16-year-old male was treated with a single lateral approach, permitting fixation with two Herbert screws. One of the two screws is inserted into the bone at the edge of the cartilage, with an anteroposterior trajectory that leaves the cartilage intact. We opted mainly for posteroanterior screw fixation in subchondral bone, which is less damaging to articular cartilage and soft tissues and has already demonstrated its reliability. No associated lesions were found, and no complications were encountered. Results were excellent, with Mayo Elbow Performance Index (MEPI) scores of 95 and 100 respectively. Herbert screw fixation therefore appears to be an option of choice for these fractures, although comparative studies are needed to evaluate the different treatments available.
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spelling doaj-art-d6167dc4afe24432bb99a4640549d7cd2025-08-20T02:05:49ZengElsevierTrauma Case Reports2352-64402024-06-015110103210.1016/j.tcr.2024.101032Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literatureRaphaël Fouché0Laela El Amiri1Nassim Bestandji2André-Pierre Uzel3University of the French Antilles, Department of Orthopedic Surgery, University Hospital of Guadeloupe, Route de Chauvel, 97139 Les Abymes, Guadeloupe; Corresponding author.Department of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, Icube CNRS 7357, University of Strasbourg, 10 Avenue Baumann, 67400 Illkirch, FranceDepartment of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, Icube CNRS 7357, University of Strasbourg, 10 Avenue Baumann, 67400 Illkirch, FranceDepartment of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, Icube CNRS 7357, University of Strasbourg, 10 Avenue Baumann, 67400 Illkirch, FranceArticular fractures of the distal humerus are rare, and even rarer are fractures involving the trochlea and capitellum in a single fragment, with no associated comminution. These fractures are classified as 2a according to the Dubberley classification and are rarely described in the literature. Two cases of Dubberley 2a fractures were treated at our hospital. The first case, involving a 68-year-old patient, was treated with a medial and a lateral approach, combined with posteroanterior fixation using 3 Herbert screws. In the 2nd case, a 16-year-old male was treated with a single lateral approach, permitting fixation with two Herbert screws. One of the two screws is inserted into the bone at the edge of the cartilage, with an anteroposterior trajectory that leaves the cartilage intact. We opted mainly for posteroanterior screw fixation in subchondral bone, which is less damaging to articular cartilage and soft tissues and has already demonstrated its reliability. No associated lesions were found, and no complications were encountered. Results were excellent, with Mayo Elbow Performance Index (MEPI) scores of 95 and 100 respectively. Herbert screw fixation therefore appears to be an option of choice for these fractures, although comparative studies are needed to evaluate the different treatments available.http://www.sciencedirect.com/science/article/pii/S2352644024000554ElbowHumerusOrthopedicsHumeral fracturesIntra-articular fractures
spellingShingle Raphaël Fouché
Laela El Amiri
Nassim Bestandji
André-Pierre Uzel
Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
Trauma Case Reports
Elbow
Humerus
Orthopedics
Humeral fractures
Intra-articular fractures
title Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
title_full Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
title_fullStr Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
title_full_unstemmed Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
title_short Articular fracture of the distal humerus classified Dubberley 2b: Case report of two patients and review of the literature
title_sort articular fracture of the distal humerus classified dubberley 2b case report of two patients and review of the literature
topic Elbow
Humerus
Orthopedics
Humeral fractures
Intra-articular fractures
url http://www.sciencedirect.com/science/article/pii/S2352644024000554
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