Internal Fixation of Distal Humerus Fractures

The distal humerus is the end of the upper arm bone, or the humerus, that forms the upper part of the elbow. A distal humerus fracture is a type of elbow fracture. The elbow consists of portions of three bones and is held together by ligaments, muscles and tendons. The distal humerus makes up the upper part of the actual elbow joint and when it is fractured, it can make elbow motion difficult or impossible.

Treatment for a fractured distal humerus varies depending on the severity of the fracture. Mild fractures may be treated with a sling or splint to hold the bone in place as it heals. Severe fractures may require surgery to position bones back into place to promote healing. This may be performed through a procedure known as internal fixation. Internal fixation is a surgical technique that secures the bones in place with the help of screws, plates, wires, rods and pins. These tools are internally attached to the bone to hold the broken parts together and initiate healing.

The Internal Fixation Procedure

During the internal fixation procedure, the patient is sedated under general anesthesia. The surgeon makes an incision in the back of the elbow. The fractured bone is set in its normal position using pins, wires, screws, sutures or a combination of these materials. The incision is then closed with sutures. The arm may be put in a splint to relieve any pressure.

Risks of Internal Fixation

As with any procedure, there are risks associated with internal fixation which may include:

  • Infection
  • Reaction to anesthesia
  • Damage to nerves and blood vessels
  • Nonunion of the bones
  • Plates, screws or wires may shift or break

In some cases, temporary numbness or weakness may occur after the procedure. This may take several weeks or months to dissipate.

Recovery from Internal Fixation

After the surgery, the elbow may be splinted or put in a cast for about two weeks. Medication may be prescribed to control pain and inflammation. The patient may be restricted from lifting objects with the injured arm for 6 to 12 weeks. A physical therapy program will be created to help restore normal muscle strength, range of motion, and flexibility. Complete recovery from internal fixation of a fractured distal humerus may take up to 6 months.

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