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Distal Humerus Fracture

Last updated May 29, 2018

Approved by: Krish Tangella MD, MBA, FCAP

A Distal Humerus Fracture is a break or crack that involves the distal region of the humerus, which forms the upper part of the elbow joint (and lower portion of the arm).


What are the other Names for this Condition? (Also known as/Synonyms)

  • Broken Elbow due to Distal Humerus Fracture
  • Fracture of the Elbow due to Distal Humerus Fracture
  • Lower Humerus Fracture 

What is Distal Humerus Fracture? (Definition/Background Information)

  • A Distal Humerus Fracture is a break or crack that involves the distal region of the humerus, which forms the upper part of the elbow joint (and lower portion of the arm)
  • It is usually caused by a high-energy impact that results from an athletic sport, motor vehicle accident, or a fall on the elbow. Only a small percentage of elbow fractures, occur in this area
  • Treatment measures for a Distal Humerus Fracture include both nonsurgical and surgical methods. The prognosis of the condition depends on the type of fracture sustained
  • Overall, individuals between 40-60 years old with osteoporosis, have an increased risk of Distal Humerus Fractures (also known as Lower Arm Fractures) 

Who gets Distal Humerus Fracture? (Age and Sex Distribution)

  • A Distal Humerus Fracture may occur in individuals of all ages, races, ethnic groups, and genders
  • Overall, middle to upper aged adults (between 40-60 years) with osteoporosis, have the highest rate of occurrence of this condition 

What are the Risk Factors for Distal Humerus Fracture? (Predisposing Factors)

The common risk factors associated with Distal Humerus Fractures include:

  • Participation in any rough or high-impact sport
  • Trauma to the arm, due to accidents
  • Reduced bone density (such as due to osteoporosis) 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Distal Humerus Fracture? (Etiology)

A few causal factors of Distal Humerus Fractures may include:

  • Taking part in any rough or high-impact sport
  • Direct trauma to the elbow associated with an automobile accident
  • A fall onto the elbows; the injury occurring especially if the individual is obese 

What are the Signs and Symptoms of Distal Humerus Fracture?

Signs and symptoms of a Distal Humerus Fracture may include:

  • Severe elbow pain at the site, where the injury occurred
  • Signs of bruising with the elbow
  • Stiffness or inability to move the arm, wrist, or elbow
  • Swelling of the elbow
  • Tenderness in the elbow on touch
  • Inability to bend or extend the elbow
  • In rare cases, pieces of bone may protrude through the skin 

How is Distal Humerus Fracture Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Distal Humerus Fracture include:

  • Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions within the elbow. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis
  • X-ray of elbow: X-rays are the most common method in evaluating a fracture, to identify if the bone has displaced. This diagnostic test can provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture
  • Computerized tomography (CT): A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues with the elbow. This diagnostic test helps a physician evaluate the severity of the injury
  • Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field to produce images that allow a physician to view any damage to the bones and soft tissue that surrounds the elbow joint 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Distal Humerus Fracture?

Complications of a Fracture at the Lower Humerus may include:

  • The immobilization required to heal such fractures may occasionally result in painful shoulder inflammation, stiffness, and reduced range of motion (a condition called frozen shoulder)
  • Permanent damage to the nerves and blood vessels
  • Abnormal deformity of the elbow
  • Abnormal pressure build-up within the muscles of the elbow that reduces blood flow and prevent nourishment and oxygen from reaching the nerve and muscle cells (compartment syndrome)
  • A disorder associated with the sympathetic nervous system (reflex sympathetic dystrophy syndrome) 

How is Distal Humerus Fracture Treated?

The treatments associated with a Distal Humerus Fracture include both nonsurgical and surgical methods. 

Nonsurgical treatment methods may include:

  • Applying ice to the elbow can help with pain and reduce swelling
  • Complete immobilization of the elbow with a cast is required to restrict movement
  • Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen may be used to treat a Distal Humerus Fracture. These medications can help decrease pain and swelling
  • Individuals are likely to need physical therapy exercises after the cast is removed. The goal of these exercises is to strengthen the muscles within the elbow, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program 

Surgical treatment methods may include:

  • Closed reduction of Distal Humerus Fracture: Closed reduction is a surgical treatment that involves realigning the fracture back to its original position without making an incision at the fracture site. This procedure is usually performed under a general anesthesia or conscious sedation with muscle relaxants
  • Open reduction and internal fixation (ORIF) of Distal Humerus Fracture: Open reduction is a surgical procedure to realign the fractured bone to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bones under the skin 

How can Distal Humerus Fracture be Prevented?

To prevent a Distal Humerus Fracture, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted. 

A few ways to further help prevent unwanted injuries or a Distal Humerus Fracture include:

  • Individuals, who participate in any high-risk sports, such as football, should wear appropriate safety equipment to help prevent the possibility of such injuries
  • Wearing appropriate footwear (such as the proper shoe size) may help prevent accidents
  • Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Distal Humerus Fracture
  • Perform weight-bearing exercises to strengthen bones 

What is the Prognosis of Distal Humerus Fracture? (Outcomes/Resolutions)

  • The long-term prognosis of Distal Humerus Fractures is usually good for a majority of individuals
  • Such fractures usually require 4-12 weeks to heal. However, severe injuries may require at least 6 months of intense physical therapy, to achieve optimal results
  • When properly treated, usually under the guidance of a physiotherapist and a specialist, a high percentage of individuals regain their full strength and range of motion in the affected arm 

Additional and Relevant Useful Information for Distal Humerus Fracture:

An elbow dislocation is a painful and traumatic injury that occurs, when the bones that make up the elbow joint is forced out of the socket, either partially or completely. 

The following article link will help you understand elbow dislocation.

http://www.dovemed.com/diseases-conditions/elbow-dislocation/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 4, 2014
Last updated: May 29, 2018