Aim: The purpose of the present retrospective study was to evaluate reasonable routine transposition of the ulnar nerve in bicondylar humeral fractures.

Material and method: From 1996 to 2007 112 bicondylar fractures were operated. 88 pateints (47 women and 41 men) were followed up for average 56 months. Average age was 48 (14–80) years. Open fractures were 17. Fractures were distributed by the AO classification as follows: type C1.2 – 16, C1.3 – 10, C2.1 – 22, C2.2 – 7, C2.3 – 3, C3.1 – 17, C3.2 – 8 and C3.3 -5. All fractures were operated by the AO method with dorsal approach, osteotomy of the olecranon (83 fractures) and fixation with 2 plates. In 47 cases the ulnar nerve was routinely anteriorly transposed and for the rest 41 patients transposition was not done.

Results: From 47 patients with routine anterior transposition 7 had Mc Gowan I dysfunction that was resolved in 3 months. From 41 patients without transposition 9 had a type Mc Gowan I dysfunction. There was no statistical significance between the two groups. (p> 0,05). However, 12 to 18 months later 3 patients from the group without transposition with type C1.3, C3.1 and C3.3 fractures returned with late postoperative nerve palsy Mc Gowan II and III. They were treated by neurolysis and transposition.

Conclusion: Routine anterior transposition of the ulnar nerve is not reasonable in every type of bicondylar humeral fractures. The type of the bicondylar fracture defines whether the nerve transposition is reasonable or not. In low bycondilar humeral fractures and type C3 fractures the nerve transposition is obligatory.

Aim: In order to determine the reliability of the ORIF of bicondylar fractures in elderly patients, we will present the results of the patients aged above 60 years in which ORIF with plates is a method of choice. Materials & Method: For the period 1996–2001 year, 20 patients with dislocated bicondylar fractures were operated with mean age Ð 70.7 (63.8). All of them were followed up Ð 14 women and 6 men. The AO types were: C1 Ð 7; C2 Ð 5; C3 Ð 8. Five patients were with þrst and second type open fractures.

Fifteen patients were operated immediately and the rest Ð between the 5th and the 10th day. The average operative time was 335 minutes. The patients were operated by the standard technique of AO. Osteotomy of the olecranon was used in all patients except for 3 patients. All the fractures were stabilised with 2 plates except for 2 patients (1 plate). The osteotomy was þxated with a tension wire and K-wires. Carefully assisted rehabilitation was started at average on the 9th day. Results: The patients were monitored for 13 to 56 months. None had serious infections. One case resulted in failure of þxation and nonunion. In order to assess the function of the elbow joint we used Morrey& Chao, DASH, and average arch of movement. Scoring: 83,02 (±24,59); 20,10 (±21,66); 97û(±37,83).Conclusions: We consider that the operative treatment with plates of the bicondylar fractures in the elderly can provide good clinical results in the hands of the experienced surgeon.