Definitive treatment in a spiral-fracture of the distal humerus shaft with severe osteoporosis after two failed osteosynthesis: Problem and solution. A case report and literature review

Introduction: Osteoporotic fractures in the elderly are often complicated by delayed union, pseudarthrosis or implant failure and are associated with considerable morbidity and prolonged reconvalescence. At present there is cumulating recommendation to treat this kind of fractures with angular stable implants. Case presentation: Herein, we report on the successful definitive treatment of a displaced comminuted spiral-fracture of the distal humerus shaft in an 89-year-old woman after two attempts of internal fixation with angular stable implants had failed in severely osteoporotic bone. Conclusion: The present case illustrates the problems we have faced with after a single locking plate fixation, especially in poor bone, and shows a possible solution by performing a double(-locking)-plate fixation.