Biplane fracture of the distal humeral lateral column: a report of two cases.

Articular fractures of the distal part of the humerus represent a challenging therapeutic problem, because they require thorough understanding of the complex local anatomy, extensile approaches, and reduction and fixation of small fragments that mainly consist of subchondral bone and articular cartilage. This report presents two cases of a unique fracture pattern of the lateral humeral column with a fracture line in the coronal plane separating the capitellum with a substantial portion of the lateral trochlear ridge, and with a second fracture line in the sagittal plane separating the residual, posterior portion of the lateral column, almost through the level of the capitellotrochlear sulcus, thus creating concomitant but distinct "low" lateral column and capitellum fractures. The radiographic findings that would suggest to the orthopaedic surgeon the possibility of this fracture pattern, the surgical approach that provides access to this complex articular fracture, and the fixation method are described.