Arm Bone Fractures (Distal Humerus Fractures): Overview

Arm Bone Fractures (Distal Humerus Fractures): Overview

This video will provide an overview of arm bone fractures, also known as distal humerus fractures. An arm bone fracture, or distal humerus fracture, is a break in the lower part of the upper arm bone near the elbow joint. The elbow joint is made of 3 bones: the humerus, or arm bone; and the ulna and radius, the forearm bones. The lower part of the humerus widens near the elbow and forms one of the joint surfaces. It is covered in smooth cartilage, allowing the bones to bend, straighten and rotate. Tendons from muscles such as the triceps and ligaments, such as the collateral ligaments, surround the elbow joint to support movement and stability of the elbow. Furthermore, several nerves and blood vessels pass through the elbow joint.

How does an arm bone fracture happen? Arm bone fractures are relatively uncommon, making up about 2% of all fractures. These injuries commonly occur in 2 groups. Older adults typically experience arm bone fractures from low-energy traumas, such as falling directly onto the elbow or falling onto an outstretched hand. Risk is higher for women and patients with osteoporosis. Younger patients typically experience arm bone fractures from high-energy traumas, such as motor vehicle accidents or sports injuries. These are more common in adolescent and young adult males. While not all injuries can be prevented, fall risk can be reduced by using handrails and keeping spaces well lit and clean of clutter, and bone health can be maintained with exercise, no smoking, and eating healthy.

After injury, patients may experience sudden pain around the elbow, swelling and bruising, difficulty or inability to move the elbow, numbness, tingling, or weakness in the hand or fingers. At the emergency room or clinic, a health care professional will: ask how the injury occurred; examine the arm and elbow for swelling, tenderness and motion; and check blood circulation and nerve function in the arm and hand. If needed, the elbow joint may be realigned and stabilized. X-rays are used to confirm the fracture and see where the bone is broken. Sometimes the forearm bones are also fractured.

If the fracture is complex, a CT scan can be taken and made into a 3D image to better visualize the fracture pieces. If the physical exam suggests nerve or blood vessel involvement, further studies may be conducted to understand the extent of the injury. The health care professional will combine the exam and imaging information to classify the arm bone fracture based on the following: whether the bones have broken the skin, where the bone is broken, how many pieces, and whether the pieces are aligned or not aligned. This classification will guide the health care professional in the decision between nonsurgical or surgical treatment. In summary, arm bone fractures are also referred to as distal humerus fractures and occur from low- or high-energy traumas to the elbow. Patients may experience pain and limited range of motion. A thorough physical examination and imaging studies will aid in understanding the complexity and the classification of the injury before recommending treatment.