6
Preparation
LCP Distal Humerus Plates
Note:
Experience in the use of the Locking Compression Plate
System LCP (see surgical technique 036.000.019) or instruction
by a surgeon with corresponding experience is recommended.
1
Position patient
The lateral decubitus position is usually chosen. In severe C3
fractures, the fully prone position can be used, if the patient is
otherwise fit. The arm is rested on a padded bar allowing
elbow flexion of 120°. In rare cases bone graft may be needed
and it is wise to prepare a donor site. The use of a tourniquet,
preferably sterile, is not essential, but can make it easier to
identify the ulnar nerve.
2
Surgical approach
All fractures are approached through a slightly curved
posterior incision just radial to the olecranon. The ulnar nerve
is gently identified and may need to be isolated and elevated
at the ulnar epicondyle.
For supracondylar fractures or simple articular fractures it may
be sufficient to expose the nerves on both sides of the triceps.
For comminuted fractures a distally pointed chevron olecranon
osteotomy exposes the fracture best.
When using longer plates the radial nerve has to be carefully
identified.
