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In case of concomitant vascular injury, the brachial artery was repaired with the use of a saphenous vein interpositional graft. In one case an intercondylar distal humeral fracture occurred after a fall of the patient having the external fixation on was treated with closed reduction and fixation with a selleck products new half pin connected to a scaffold bridging the elbow (Fig. 3). In almost all the cases, the mobilisation of the upper limb was initiated immediately after the operation. The patients following their discharge followed a consistent rehabilitation program and were reviewed clinically and radiographically on a monthly basis until completion of fracture healing. The clinical evaluation was performed using the Constant score8 for the shoulder function, and the Mayo Elbow Performance Index22 (MEPI) for the elbow function. Radiographic fracture consolidation was decided in the presence of cortical bridging in at least 3 out of the 4 cortexes as evident in Calpain the anteroposterior, lateral and oblique views. The Constant score8 takes into account eight parameters with a maximum summation of 100 points. It records pain (max 15 points), daily life activities capacity (max 10 points), joint movement (max 10 points), abduction (max 10 points), internal rotation (max 10 points), external rotation (max 10 points), anterior elevation (max 10 points), and strength (max 25 points). The recorded results are characterised as ��excellent�� if >95, ��good�� if between 75 and 94, ��fair�� if between 60 and 74, and ��poor�� if ?95, good if between 75 and 94, fair if between 60 and 74, and poor if Selleckchem Erlotinib to the AO/OTA classification21 there were 24 (28.6%) type A, 38 (45.2%) type B, and 22 (26.2%) type C. Half of the cases were attributed to a mechanical fall and the rest to road traffic accidents. The average time of the operation was 30?min (range 18�C50?min), while the average in hospital stay was 8 days (including polytrauma cases). The post-operative hospital stay for the isolated humeral fractures was 3.5 day (range from 2 to 5 days). The average time until removal of the external fixator was 95 days (range from 58 to 140 days). At 6 months all fractures were radiologically healed.