Distal humeral fracture

From WikiMD's medical encyclopedia

An overview of distal humeral fractures


Distal Humeral Fracture

A distal humeral fracture is a break in the lower end of the humerus, the bone of the upper arm, near the elbow joint. These fractures are common in both children and adults and can result from direct trauma or falls onto an outstretched arm.

X-ray of a supracondylar fracture of the humerus

Anatomy

The distal humerus is the lower part of the humerus that articulates with the radius and ulna at the elbow. It consists of the medial epicondyle, lateral epicondyle, trochlea, and capitulum. The distal humerus is crucial for the movement and stability of the elbow joint.

Types of Fractures

Distal humeral fractures can be classified into several types based on their location and pattern:

Supracondylar Fractures

These occur just above the condyles of the humerus and are most common in children. They are often caused by falls on an outstretched hand.

Intercondylar Fractures

These involve the area between the condyles and are more common in adults. They can be complex and involve multiple fracture lines.

Transcondylar Fractures

These occur through the condyles and are less common. They can result from direct trauma to the elbow.

Symptoms

Symptoms of a distal humeral fracture include:

  • Severe pain in the elbow or upper arm
  • Swelling and bruising around the elbow
  • Inability to move the elbow
  • Visible deformity in severe cases

Diagnosis

Diagnosis is typically made through a combination of physical examination and imaging studies. X-rays are the primary imaging modality used to assess the fracture pattern and displacement. In some cases, CT scans may be used for more detailed evaluation.

Treatment

Treatment of distal humeral fractures depends on the type and severity of the fracture:

Non-Surgical Treatment

Non-displaced fractures may be treated with immobilization using a cast or splint. This allows the bone to heal naturally over time.

Surgical Treatment

Displaced or complex fractures often require surgical intervention. Common surgical procedures include:

  • Open reduction and internal fixation (ORIF)
  • External fixation
  • Elbow replacement in severe cases

Rehabilitation

Rehabilitation is crucial for restoring function after a distal humeral fracture. Physical therapy exercises are used to regain range of motion and strength in the elbow.

Complications

Potential complications of distal humeral fractures include:

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Contributors: Prab R. Tumpati, MD