A distal humerus fracture is a fracture of the lower end of the humerus (arm bone) that forms part of the elbow joint. The injury usually results from a fall and commonly occurs in individuals over the age of 60 years. The injury may also occur in younger individuals often resulting from high-energy trauma from cycling or vehicular accidents. 

Distal humerus fracture

How is a distal humerus fracture diagnosed?

Fractures of the distal humerus may be suspected from the mechanism of injury resulting in pain, deformity and bruising over the outer aspect of the elbow. The diagnosis is confirmed on X-rays of the elbow. In most instances a CT scan will be arranged to study the fracture in greater detail and help plan surgical treatment.

How is a distal humerus fracture treated?

Non-operative treatment

The initial treatment will consist of supporting the arm in a sling, the use of oral pain medication and advice on protection of the elbow. Whilst your arm is in a sling you will be advised to keep the fingers, wrist and shoulder moving to prevent stiffness. As the pain in the elbow settles, you will be encouraged to start gradually moving the elbow. If the fracture is not displaced and the movements of the elbow are not impeded, this treatment is continued until the fracture has healed.

Surgical treatment

In cases where the fracture is displaced or fragmented surgical treatment is the preferred option. The exact nature of the operation will depend on the location and pattern of the fracture.

Internal fixation: This is the preferred method of treatment in displaced fractures of the distal humerus in younger individuals and in those in whom the bone is not too severely fragmented. It consists of realigning the fragments of bone to restore the shape of the bone and then fixing the fragments with screws with or without a plate, which hold the position of the fragments until the fracture has healed. The fracture will usually go on to heal over a period of 3 to 6 months.

Hemiarthroplasty (partial elbow replacement): In patients over the age of 65 years, owing to osteoporosis, fractures of the distal humerus are sometimes severely fragmented and may not be amenable to repair. These fractures may be treated with hemiarthroplasty (or partial elbow replacement).

How long does it take to recover from a distal humerus fracture?

Recovery will depend to some extent on the severity of the fracture and the type of treatment. Pain usually starts easing within a couple of weeks. You may start using the hand and elbow, as the arm gets comfortable. Office duties may be resumed within 2-3 weeks. Strenuous task should be avoided until the fracture has healed over a period of 3-6 months.