Objective: To assess improvements in fixation stability when a hinged unilateral external fixator is used to supplement compromised internal fixation for distal humerus fractures. achieving union of the bony fragments for fractures of the distal humerus. [10] [11] [12] Clearly, obtaining initial rigid fracture fixation is critical in limited number of screws in the proximal or distal fragments. 11 and extension of the elbow for supplemented fixation were found to anterior/posterior

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... of the distal fragment during flexion Methods: Removing a 1-cm section of the distal humerus in cadav eric whole-arm specimens created a comminuted distal humerus fracture model (AO type 13-A3). Fixation was then performed using different constructs representing optimal, compromised, or supple mented internal fixation. Internal fixation consisted of either 2 recon struction plates with 1, 2, or 3 (optimal) distal attachment screws, or crossing medial and lateral cortical screws. A hinged external fixator was applied in combination with compromised internal fixation. The stability of the different constructs was then evaluated using 3-point bending stiffness and distal fragment displacement measurements during flexion and extension testing.