Upper Arm Fractures and Dislocations

The humerus is the long arm bone located between the elbow and the shoulder, with the distal end located closest to the elbow. Fractures of the distal humerus are less common than other upper body fractures and account for less than 3 percent of fractures in adults. But, they are among the most challenging fractures to treat.

A direct blow to the back of the upper arm, when the elbow is in a flexed position, or a severe fall usually causes this type of fracture. It can also result from a high impact trauma such as an automobile or motorcycle accident.

At the distal end of the humerus, near the elbow, there are two projections known as condyles – the medial epicondyle (the site of medial epicondylitis or Golfer’s Elbow) and the lateral epicondyle (the site of lateral epicondylitis or Tennis Elbow). These are the areas of attachment for the muscles that facilitate forearm movement. Distal Humerus fractures often affect both condyles and extend into the elbow joint. Damage to soft tissue around the affected area may also exist – including nerves, tendons, ligaments and blood vessels.

Among the symptoms of a distal humerus fracture include: pain, swelling, restricted movement, and possibly skin discoloration that accompanies a blood vessel rupture and slight deformity, if bone fragments have separated and affected normal arm contour.

Treatment
Depending on the severity of the fracture, either conservative or surgical treatment will be indicated. For fractures that are nondisplaced, splinting for a period of approximately 10 days, combined with anti-inflammatory medication to help with pain and swelling is all that is required.

More serious fractures require surgery and internal fixation, followed by a targeted rehabilitation and range of motion exercise program.