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Jennifer Lucas - Jun 11, 2023 - 7 min read - 1k Likes

Understanding Distal Humerus Fracture: Causes, Symptoms, and Treatment

A distal humerus fracture is a break in the lower end of the humerus bone that connects to the elbow joint. It commonly occurs in adults, especially those over 60 years old, and can be caused by trauma, such as a fall or direct blow to the elbow.

The symptoms of a distal humerus fracture can include severe pain, swelling, and difficulty moving the elbow. In some cases, a visible deformity or the feeling of bone fragments moving around in the arm may also be present.

Treatment options for a distal humerus fracture vary depending on the severity of the injury. Non-surgical options include immobilization with a cast or brace, pain management, and physical therapy. Surgical interventions may involve open reduction and internal fixation, total elbow arthroplasty, or other procedures.

If you have a distal humerus fracture or suspect that you may have one, it is important to seek medical attention as soon as possible. In this article, we will provide a comprehensive overview of distal humerus fractures, including their causes, symptoms, treatment options, rehabilitation, and prevention strategies.

What is a Distal Humerus Fracture?

distal humerus fracture broken elbow fracture

A distal humerus fracture is a type of elbow fracture that occurs in the lower end of the humerus bone, near the elbow joint. It can be caused by a direct blow to the elbow or a fall onto an outstretched hand. This type of fracture is relatively uncommon and accounts for only around 2% of all fractures in adults.

There are several different types of elbow fractures, and it is essential to distinguish a distal humerus fracture from other types. For example, radial head fractures occur at the top of the elbow joint, while olecranon fractures occur at the tip of the elbow.

Distal humerus fractures can happen to anyone, but they are more common in older adults due to the decreased bone density that comes with aging. Additionally, athletes who participate in high-impact activities, such as football or hockey, may be at increased risk for this type of injury.

Signs and Symptoms of a Distal Humerus Fracture

A distal humerus fracture is a serious injury that can cause significant pain and limited range of motion in the affected arm. The most common signs and symptoms of this type of fracture include:

  • Severe pain in the elbow
  • Swelling and bruising around the elbow joint
  • Inability to straighten or bend the arm
  • Tenderness when touched
  • Numbness or tingling in the forearm or hand

If you experience any of these symptoms after an injury, it is important to seek medical attention right away. Only a medical professional can properly diagnose a distal humerus fracture and recommend the appropriate treatment plan.

“A distal humerus fracture can be a serious injury that requires prompt diagnosis and appropriate treatment to ensure the best possible outcome for the patient.”

Your doctor will conduct a physical examination and may order imaging tests such as an X-ray or MRI to confirm the diagnosis and determine the severity of the injury. Based on the findings, they will recommend a treatment plan that is tailored to your individual needs and goals.

Types of Distal Humerus Fractures

A distal humerus fracture can occur in several different ways, resulting in various types of fractures. The different types of fractures can be classified based on the location and pattern of the break. Understanding the type of fracture is important in determining the most effective treatment plan and expected recovery time. Here are some of the most common types of distal humerus fractures:

Type of Fracture Description
Supracondylar Fractures A break above the elbow joint that can cause the bone to shift out of place.
Intercondylar Fractures A rare type of fracture that occurs in the center of the elbow joint, often requiring surgical intervention.
Transolecranon Fractures A break that extends from the elbow joint to the back of the forearm, often requiring surgical intervention.

Other less common types of fractures can include a lateral condyle fracture or a medial epicondyle avulsion fracture. It is essential to consult with a medical professional to determine the type of fracture and the most appropriate course of action.

Non-Surgical Intervention for Distal Humerus Fracture

A distal humerus fracture refers to a break in the lower end of the humerus bone near the elbow joint. While surgical intervention is often the preferred treatment for distal humerus fractures, non-surgical interventions may be considered in certain cases. It’s important to note that the choice of treatment depends on various factors such as the specific characteristics of the fracture, patient age, overall health, and the individual’s functional requirements. Non-surgical interventions for distal humerus fractures include:

  1. Closed Reduction and Immobilization: In some cases, the fracture fragments can be realigned (reduced) without surgery. This is typically done under local or general anesthesia. Once the alignment is achieved, the arm is immobilized using a cast or splint to maintain stability during the healing process. Regular follow-up visits and imaging are necessary to ensure proper alignment and healing.
  2. Traction and External Fixation: Traction involves applying a pulling force to the affected arm using weights, ropes, or pulleys. This technique may be used to align the fracture fragments before applying an external fixator. An external fixator is a metal device that is placed outside the body, attached to the bone with pins or wires. It provides stability and support to the fracture while allowing for adjustment as the healing progresses.
  3. Functional Bracing: In certain cases, a functional brace may be used as an alternative to surgery. This is more commonly considered for non-displaced or minimally displaced fractures. The brace provides support and allows controlled motion of the elbow while promoting healing. Close monitoring and regular follow-up visits are necessary to assess fracture alignment and ensure proper healing.

It’s important to note that non-surgical interventions may have limitations and are generally not recommended for all types of distal humerus fractures. In cases where the fracture is severely displaced, unstable, or involves multiple fragments, surgical intervention, such as open reduction and internal fixation (ORIF) or total elbow replacement, may be necessary to achieve optimal outcomes. The final decision regarding the treatment approach should be made by a qualified orthopedic specialist based on individual circumstances and considerations.

Surgical Intervention for Distal Humerus Fracture

orthopedic surgeon doing distal humerus fracture surgery

Surgical intervention for distal humerus fracture is typically recommended when the fracture is severe, involves multiple pieces, or when the joint is dislocated. Surgery may also be necessary in cases where non-surgical treatments have failed to heal the fracture or when the patient requires immediate mobility.

The most common surgical procedure for distal humerus fracture is open reduction and internal fixation (ORIF). This involves making an incision to access the fractured bone, realigning the bone fragments, and then securing them in place with metal plates and screws. The use of intramedullary nails, which are inserted into the bone, is another option for fixation.

In other cases, total elbow arthroplasty (TEA) may be necessary, particularly when the joint is severely damaged or when the patient has existing joint diseases like arthritis. This procedure involves replacing the damaged joint with an artificial implant that allows for smoother joint movement.

Other less common surgical procedures for distal humerus fracture include external fixation and radial head excision. In external fixation, metal pins are inserted into the bone and connected to an external frame that holds the bone fragments in place. Radial head excision, on the other hand, involves removing the head of the radius bone, which can help to reduce pain and restore mobility.

It is important to note that all surgical procedures come with risks, including infection, nerve and blood vessel damage, and improper healing. Patients should discuss the potential benefits and risks of each procedure with their healthcare provider before making a decision.

Rehabilitation After Distal Humerus Fracture

Rehabilitation after a distal humerus fracture is critical to restore limb function and minimize the risk of future complications. The length of rehabilitation and the specific exercises involved will depend on the severity of the injury, any surgical procedures performed, and the patient’s overall physical health.

Physical therapy is typically recommended for patients with distal humerus fractures. At first, therapy may focus on gentle range-of-motion exercises and pain management techniques. As the patient’s condition improves, exercises to strengthen the muscles and increase flexibility may be introduced.

It is important to note that rehabilitation after a distal humerus fracture can be a long and challenging process. Patients may experience discomfort and difficulty performing certain movements, particularly in the initial stages of therapy. Patients are advised to be patient and to work closely with their physical therapist to ensure they are properly executing exercises and progressing towards their recovery goals.

Physical Therapy Goals

The primary goal of physical therapy after a distal humerus fracture is to restore full range of motion to the elbow and forearm. This may involve exercises to stretch and mobilize the joint and surrounding muscles. During these exercises, the therapist may apply gentle pressure to the joint to help loosen any adhesions or scar tissue that may have formed.

Another important goal of physical therapy is to strengthen the muscles that surround the elbow. Strengthening exercises may involve the use of weights or resistance bands to increase muscle mass and improve joint stability.

Duration of Rehabilitation

The length of rehabilitation after a distal humerus fracture can vary widely, depending on the severity of the injury and the specific treatment approach used. In general, patients can expect to attend physical therapy sessions for several weeks or months following the initial injury or surgery.

During the course of rehabilitation, patients will typically begin with simple exercises that are easy to perform and gradually progress to more challenging activities as their strength and range of motion improves. Patients should expect to work with their physical therapist closely throughout this process to ensure they are progressing safely and effectively.

Challenges During Rehabilitation

Patients undergoing rehabilitation for a distal humerus fracture may face a number of challenges. These can include discomfort and pain during exercises, difficulty performing certain movements, and temporary loss of strength and mobility in the affected limb.

Patients are encouraged to communicate closely with their physical therapist throughout the rehabilitation process to ensure they are properly managing any discomfort or challenges that arise. With patience and diligence, most patients are able to make a full recovery following a distal humerus fracture.

Preventing Distal Humerus Fractures

older woman doing stretches to avoid distal humerus fracture

While a distal humerus fracture can occur suddenly and unexpectedly, there are certain strategies that can be employed to help prevent these injuries from happening in the first place. Below are some strategies to follow:

  • Proper training techniques: Ensuring that you use proper techniques when exercising or participating in sports can go a long way in preventing distal humerus fractures. Make sure to use proper form and technique when lifting weights or performing other exercises.
  • Stretching: Stretching before exercising or participating in sports can also help prevent distal humerus fractures. This can help to improve flexibility and reduce the risk of injury.
  • Use of protective equipment: When participating in high-risk activities or sports, it is important to use protective equipment. This may include helmets, elbow pads, or other gear that can help to protect the elbow from injury.

By following these strategies, you can reduce the risk of experiencing a distal humerus fracture and keep your elbow healthy and injury-free.

Common Questions About Distal Humerus Fractures

Here are some of the most common questions people have regarding distal humerus fractures:

How is a distal humerus fracture diagnosed?

A distal humerus fracture is usually diagnosed through a combination of physical examination, medical history, and imaging tests such as X-rays, CT scans or MRI scans.

What are the treatment options for a distal humerus fracture?

The treatment options for a distal humerus fracture depend on the severity of the fracture. Non-surgical options including immobilization, pain management, and physical therapy may be used for less severe fractures. More serious fractures may require surgical intervention such as open reduction and internal fixation or total elbow arthroplasty.

How long is the recovery process?

Recovery time can vary depending on the severity of the fracture and the treatment used. Generally, non-surgical treatments may require several weeks of immobilization followed by several months of physical therapy. Surgical intervention may require longer recovery time, possibly up to a year.

What are the potential complications of a distal humerus fracture?

Potential complications include nerve or blood vessel damage, infection, and stiffness in the elbow joint. These complications can often be managed with proper medical care and rehabilitation.

How can distal humerus fractures be prevented?

Prevention strategies include proper training techniques, avoiding overuse of the elbow joint, and using protective equipment such as elbow pads when participating in sports or other activities that put the elbow at risk.

When can I return to my normal activities after a distal humerus fracture?

The timeline for returning to normal activities will depend on the severity of the injury and the treatment used. It is important to follow the advice and guidance of your medical team during the recovery process to ensure the best outcomes.

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Jennifer Lucas - Author

As an accomplished Orthopedic Surgeon, I am dedicated to the comprehensive care and treatment of musculoskeletal conditions. With a commitment to excellence, I specialize in diagnosing and managing a diverse range of orthopedic issues, including fractures, joint disorders, and sports-related injuries.

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