Intercondylar T or Y Fractures

Intercondylar fractures are much more common in adults than in children. Any distal humerus fracture in an adult should initially be assumed to be intercondylar rather than supracondylar (Fig 261-4). A careful search should be made for a fracture line separating the condyles from each other and from the humerus. This distinguishes intercondylar T or Y fractures from other fractures of the distal humerus.

The mechanism of injury is a force directed against the elbow, driving the olecranon against the humeral articular surface separating the condyles and producing the typical fracture. These fractures are associated with severe soft-tissue injuries. Treatment in the young is directed at anatomic reduction. In older patients with severe injuries, treatment is often directed at joint motion through nonoperative means. As in supracondylar fractures, patients with severe swelling or displaced fractures should be admitted.

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