{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:40:10Z","timestamp":1756370410479,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,21]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>The unique anatomy of the distal humerus predisposes it to coronal shear injuries of its articular appendages. These injuries often require an open reduction and internal fixation of articular fragments. The existing classification systems often overlook the depth of sub-chondral bone involvement. This case report discusses a rare variant of a distal humerus articular injury which involved an \u2018en-bloc separation of the anterior articular cartilage\u2019. A young male in his 20s presented with a coronal shear fracture of the distal humerus, fixed using combined lateral and medial surgical approaches to the elbow. Postoperatively, a favourable functional outcome was observed at the 13\u2009month follow-up mark, emphasising the importance of early fixation and rehabilitation. Our case can be categorised as a rare variant of the Bryan and Morrey Type IV fracture. This case also contributes valuable insights into the management of such complex fractures, emphasising the need for individualised surgical approaches and preoperative planning.<\/jats:p>","DOI":"10.1136\/bcr-2024-259935","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T04:16:08Z","timestamp":1749096968000},"page":"e259935","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["En-Bloc separation of the distal humerus articular appendage"],"prefix":"10.1136","volume":"18","author":[{"given":"Prasoon","family":"Kumar","sequence":"first","affiliation":[{"name":"Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6836-4893","authenticated-orcid":false,"given":"Tarkik","family":"Thami","sequence":"additional","affiliation":[{"name":"Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5541-6298","authenticated-orcid":false,"given":"Ankit","family":"Dadra","sequence":"additional","affiliation":[{"name":"Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2025082801242806000_18.6.e259935.1","doi-asserted-by":"crossref","unstructured":"Paoloni M , Agostini F , Bettinelli A , et al . 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