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Better functional results are obtained in patients with less comorbidities.Worse functional results are obtained in patients taking more drugs, in women, alcohol consumers and those after proximal humeral fractures. Preoperative clinical status must be optimized and the patients' comorbidities should be carefully taken into accounting order to ascertain the correct shoulder arthroplasty.

When treating a distal humeral shear fracture, comminution of the lateral column may preclude the reconstruction of the lateral articular fragments.In this article a new strategy for the management lateral column comminuted shear-fractures (LCCSF) is presented, called the “built-on” surgical technique. Three goals are obtained by this technique: (1) Restoration of the lateral column bone stock; (2) Provision of a solid scaffold for the repair of the lateral ulnar collateral ligament (LUCL); and (3) Provision of a sable platform for the reconstruction and fixation of the articular fragments.We will obtain these goals through the following surgical steps:1/ Reconstruction of the lateral trochlea.2/ Reconstruction of the lateral column3/ Fixation of the Capitellum4/ Reconstruction of the LUCL