ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2026
The Incidence and Diagnosis of Intra-articular Extension With Spiral Distal Third Humerus Fractures.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeMany orthopaedic injuries have associated fracture patterns that require specific diagnostic tests. The relationship between spiral distal humeral shaft fractures and intra-articular extension has not been previously assessed. The purpose of this study was therefore to identify whether there is an association between spiral distal humeral shaft fractures and intra-articular extension.
methodsWe conducted a retrospective review of patients with spiral distal third humeral shaft fractures (12A1, 12B1, and 12C1) from 2016 to 2021 at a single institution. We queried our electronic medical record using CPT codes (24500, 24505, 24515, and 24516) and ICD10 codes (S42.3 and S42.4). Inclusion criteria consisted of patients older than 17 years, spiral distal third humeral shaft fractures (12A1, 12B1, and 12C1), and patients with appropriate radiographic imaging. We recorded OTA fracture classification, presence of CT scan, and presence of intra-articular extension.
resultsNine hundred seventeen patients were identified with humeral shaft fractures. Of those, 57 patients were included in the study with spiral distal third humerus fractures. One patient (1.8%) had intra-articular extension. Thirty patients had CT scans of the distal humerus; no additional cases of intra-articular extension beyond the single radiographically identified fracture were detected.
conclusionDistal third spiral humeral shaft fractures (AO/OTA 12A1, 12B1, and 12C1) rarely demonstrate intra-articular extension. In our cohort, only 1 case showed articular involvement and was apparent on initial radiographs. Therefore, routine CT imaging is not indicated for these fractures and should be reserved for patients with concerning clinical findings or radiographic features suggestive of intra-articular extension.
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