1. 13-A2.1/2 Oblique downwards
13-A2 oblique downwards (and inwards = A2.1)
This fracture may occur in a young patient with strong bone. Shear forces lead to an oblique separation of the metaphyseal/articular block from the shaft. Due to strong rotational forces at the level of the elbow, stabilization with plates on the ulnar and radial columns is preferred. The plates should be applied in a compression mode.
The obliquity of the fracture plane can be in either direction: A2.1 passes obliquely downwards and inwards, and A2.2 obliquely downwards and outwards.
13-A2.1 oblique downwards and inwardsImage taken from Orozco R, et al. (1998) Atlas of Internal Fixation. Used with kind permission.
2. 13-A2.3 Transverse
These are transverse fractures of the distal humeral metaphysis.
The typical patient with this fracture is an elderly woman with osteoporotic bone. Articular involvement may be present, but may not be obvious on the initial x-rays.
13-A2.3 transverse