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Open reduction and internal fixation with 90-90 plating of bicolumn distal humeral fractures.

A bicolumn intra-articular fracture is the most challenging distal humeral fracture to treat. Open reduction and internal fixation of these fractures is best achieved using either 90-90 medial-lateral or parallel opposing plates. Either technique can be used to treat most patients, although in some instances, one technique may be preferred over another. The goal of treatment is accurate anatomic restoration and stable fixation that will permit early range of motion.