Treatment of severely comminuted fractures of the elbow long has been a subject of controversy, and basically is represented by two schools of thought: the school that favors closed methods, and the one that prefers open methods. This report primarily reviews the methods of treatment of these fractures and secondarily presents the results of the authors' experience in open treatment of them. It is concluded that comminuted fractures of the elbow do not present hopeless situations. Rather, in the hands of a competent surgeon, open reduction with anatomic assemblage and internal fixation of the fragments offers a sufficiently high return in good results in selected cases to merit the additional hazards entailed.
Bickel WE, Perry RE. Comminuted Fractures of the Distal Humerus. JAMA. 1963;184(7):553-557. doi:10.1001/jama.1963.03700200075014