Distal Humerus Fracture
The three bones that come together to form the elbow can break (fracture) in different ways. A distal humerus fracture is one type of elbow fracture. The distal humerus is the end of the upper arm bone (the humerus) that forms the upper part of the elbow.
These types of elbow fractures are fairly uncommon. They account for about 2% of fractures in adults.
The elbow is a complicated joint and elbow fractures can involve both of the forearm bones, as well as the humerus.
A fracture of the distal humerus occurs when there is a break anywhere within the distal region (lower end) of the humerus
Distal humerus fractures are fairly uncommon. They may occur in an isolated manner (that is, there are no other injuries), but can also be a part of a more complex elbow injury.
Cause
Distal humerus fractures may occur in a number of ways:
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A direct blow. This can happen during a fall (landing directly on the elbow) or by being struck by a hard object (baseball bat, car dashboard or door during a crash).
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An indirect fracture. This can happen during a fall if a person lands on his or her outstretched arm with the elbow locked straight. The ulna (one of the forearm bones) is driven into the distal humerus, causing it to break.
Symptoms
Distal humerus fractures can be very painful and may prevent the patient from moving his or her elbow. Additional symptoms include:
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Swelling
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Bruising
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Pain or tenderness to the touch
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Stiffness
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Feeling of instability (“my elbow feels like it wants to pop out”)
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Pieces of bone may stick out of the skin (rare)
Swelling
Bruising
Pain or tenderness to the touch
Stiffness
Feeling of instability (“my elbow feels like it wants to pop out”)
Pieces of bone may stick out of the skin (rare)
Diagnosis
Physical Examination & Patient History
During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy. Most injuries can be diagnosed with a thorough physical examination.
Imaging Tests
Imaging Tests Other tests which may help your doctor confirm your diagnosis include:
X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.
Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.
Treatment Options
While in the emergency room, the doctor will apply a splint (like a cast) to the elbow and provide a sling to keep the elbow in position. Additional immediate treatment will include applying ice to the elbow and giving the patient pain medicine.
Many distal humerus fractures require surgery, but some stable fractures can be treated without an operation.
Nonsurgical Treatment
If the fracture is not displaced, it may require just a splint or sling to hold the elbow in place during the healing process. The doctor will closely monitor the healing of the fracture, and have the patient return to the clinic for x-rays fairly frequently.
If none of the bone fragments are out of place after a few weeks, the doctor will allow the patient to begin gently moving the elbow. This may require visits with a physical therapist.
The patient will not be allowed to lift anything with the injured arm for a few weeks.
A nonsurgical approach to a distal humerus fracture may require long periods of splinting or casting. The elbow may become very stiff and require a longer period of therapy to regain motion after the cast is removed.
If the fracture shifts in position, the patient may require surgery to put the bones back together.
Surgical Treatment
Surgery for a distal humerus fracture typically involves putting the pieces of the fractured bone back where they belong. Metal implants — such as plates and screws — are used to hold things in place until the bone is fully healed.
Surgical Indications
Surgery is usually necessary when:
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The fracture is out of place (displaced)
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The fracture is open (pieces of bone have cut the skin).Because the risk of infection is higher in an open fracture, the patient will receive antibiotics by vein (intravenous) in the emergency room, and may require a tetanus shot. The patient will promptly be taken to surgery so that the cuts can be thoroughly cleaned out. The bone will typically be fixed or replaced during the same surgery.
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In some cases of severe, open fractures, the doctor may choose to apply an external fixator (bars and pins in the bone outside the surface of the skin) to temporarily hold the bones in place. This gives the skin time to improve before surgery to fix the fracture, and may reduce the risk of infection.
Conservative Treatment Options
Treatment Highlights
Tenex FAST Procedure
Tenex FAST Procedure
Tenex FAST procedure is an innovative procedure utilized by Dr. Paul Abeyta to address Tennis Elbow – Elbow Epicondylitis injuries and accelerate the treatment options available to patients.
Procedure Advantages:
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Removes damaged tissue through a microincision and stimulates healing response. Uses gentle ultrasonic technology
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Involves no general anesthesia or stitches. Local anesthetic (numbing medicine) only. Twenty minutes or less to perform. No need for physical therapy or additional treatments. Your individual results may vary.
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Full return to normal activity in 6 weeks or less. Your individual results may vary.
Peninsula Bone & Joint Clinic
The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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