Fig. 2.

Fracture of the distal humerus with severe comminution in 48-year-old female after a car accident. A: anteroposterior and lateral radiographs of the right elbow. B: anteroposterior and lateral radiographs of the elbow showing unstable osteosynthesis of the fracture (poor surgical technique) with two one-third tubular plates and a K-wire without olecranon osteotomy. C: CT-scan of the elbow eight months postoperative showing nonunion in the supracondylar area. D: second operation using two anatomic locking plates, without olecranon osteotomy. E: anteroposterior and lateral radiographs of the elbow showing nonunion in the supracondylar area. F: anteroposterior and lateral radiographs of the elbow after a third operation with two anatomic precountour locking plates, bone graft and olecranon osteotomy. G: anteroposterior and lateral radiographs eight months postoperative showing union at the supracondylar area. H: range of motion of the right elbow, with lack of extension (10^o) and full flexion.