A distal humerus fracture is a break in the lower end of the upper arm bone (humerus), near the elbow joint. It involves one of the three bones that form the elbow joint – the humerus, radius, and ulna. The fracture can range from a minor crack to the bone breaking into multiple pieces (comminuted fracture), with the broken pieces either aligned or displaced.

Common Symptoms

• Severe pain in the elbow area
• Swelling and bruising around the elbow
• Inability to move the elbow joint
• Instability or feeling like the elbow will “pop out”
• In severe cases, the fractured bone may protrude through the skin (open fracture)

Cause & Anatomy

The elbow is a hinge joint formed by the humerus, radius, and ulna bones. The distal humerus is the lower end of the humerus that forms the upper part of the elbow joint. Distal humerus fractures are commonly caused by:

• Falling directly onto the elbow
• Direct blow to the elbow (e.g., from a baseball bat or car accident)
• Falling onto an outstretched arm, driving the ulna into the distal humerus
• In older adults with weakened bones (osteoporosis), even minor falls can cause these fractures.

Diagnosis

• Physical examination to check for swelling, bruising, tenderness, and instability
• Checking for cuts, lacerations, or open fractures
• Assessing pulse and finger/wrist movement to check for nerve or blood vessel damage
• X-rays to determine the location, extent, and displacement of the fracture
• In some cases, MRI may be needed to check for soft tissue damage.

Prevention

Distal humerus fractures are typically caused by trauma or falls, so prevention involves taking precautions to avoid such incidents, especially for older adults with osteoporosis who are at higher risk.

Non-Surgical Treatment

• Splinting or casting to immobilize the joint during healing
• Ice packs, pain medication, and antibiotics (for open fractures)

Surgery

Surgical treatment is often required:

• Open reduction and internal fixation using plates, screws, wires to stabilize the bone fragments
• Bone grafting or fillers may be used for severe fractures with bone loss
• Total elbow replacement surgery for cases with extensive joint damage

Rehabilitation

After surgery or immobilization, physical therapy is crucial to regain strength, mobility, and range of motion in the elbow joint. Intensive therapy may be required to prevent stiffness and loss of motion, which are common complications.

FAQ’s

How long does it take to recover from a distal humerus fracture?
Recovery time varies based on the severity of the fracture, but typically ranges from 3-6 months for non-surgical cases and 6-12 months for surgical cases involving extensive rehabilitation.

What are the potential complications of distal humerus fractures?
Common complications include loss of motion (stiffness), post-traumatic arthritis, numbness, weakness, nerve damage, and heterotopic ossification (abnormal bone growth in soft tissues).

Can distal humerus fractures heal without surgery?
Minor, non-displaced fractures may heal with immobilization alone, but most displaced or comminuted fractures require surgery to realign and stabilize the bone fragments.

Is physical therapy necessary after a distal humerus fracture?
Yes, physical therapy is crucial to regain strength, mobility, and range of motion in the elbow joint after immobilization or surgery for a distal humerus fracture.