What is it?
A distal humerus fracture is a break in the lower end of the upper arm bone (humerus), one of the three bones that come together to form the elbow joint. A fracture in this area can be very painful and make elbow motion difficult or impossible.
Most distal humerus fractures are caused by high—energy events, such as receiving a direct blow to the elbow during a car collision. However, in an older person who has weaker bones, even a minor fall may be enough to cause a fracture.
Treatment for a distal humerus fracture usually involves surgery to restore the normal anatomy and motion of the elbow.
What are the causes?
Distal humerus fractures are most often caused by:
⦁ Falling directly on the elbow
⦁ Receiving a direct blow to the elbow from something hard, like a baseball bat or a dashboard or car door during a vehicle collision
⦁ Falling on an outstretched arm with the elbow held tightly to brace against the fall.
⦁ Pathological fracture
What are the symptoms?
A distal humerus fracture may be very painful and can prevent you from moving your elbow.
Other signs and symptoms of a fracture may include:
⦁ Swelling
⦁ Bruising
⦁ Tenderness to the touch
⦁ Stiffness
⦁ A feeling of instability in the joint, as if your elbow is going to “pop out.”
⦁ In rare cases, the fractured bone may stick out of the skin (open fracture)
Treatment
Non-Surgical Treatment
Although rare, non-surgical treatment may be recommended for stable fractures where the bone fragments are not displaced. It is also recommended for patients at high risk of surgical complications.
Splints are usually worn for six weeks before controlled movement is initiated. If the fracture shifts during this time, surgery to reunite the bones may be required.
Surgical Treatment
Surgery is usually required for distal humerus fractures where:
⦁ The bone has shifted (displaced fracture)
⦁ Pieces of bone have penetrated the skin (open fracture)
Because of the increased risk of infection, surgery for open fractures is scheduled as soon as possible, usually within hours.
Surgical Procedures
Open Reduction and Internal FixationThis is the most commonly used procedure for treating fractures of the distal humerus. During this procedure, the bone fragments are realigned (reduced) and then held in place with plates and screws attached to the outside of the bone.
External Fixation
In severe open fractures, an external fixator may be used to hold the bones in place until a second surgery is performed.
Total Elbow Replacement (Arthroplasty)
In some cases, the humerus bone is so severely damaged that it cannot be adequately repaired and requires replacement.
In elbow replacement surgery, a metal and plastic implant is attached to the humerus bone after the broken bone has been removed. Another metal and plastic implant is attached to the ulna (forearm bone), and the two implants are joined to form a joint. These implants can be held in place with bone cement.
Advanced Options
Total Elbow Replacement (TEA): Partial replacement of the joint for complex fractures, usually in older adults with weaker bones.
What Happens After Surgery?
- First week: Elbow in a protective splint (~70° bent).
- Early rehab: You’ll start gentle movements almost right away.
- Strength training: Begins after scans show healing (usually 8–12 weeks).
- Activity limits: Avoid heavy lifting—especially important if you have a prosthetic elbow.
Possible Complications & How We Prevent Them
Problem | What It Means | Prevention / Treatment |
Stiffness | Difficulty bending or straightening elbow | Early motion therapy and regular exercises |
Nerve Injury | Numbness or weakness, especially in ring/pinky finger | Careful nerve protection during surgery |
Extra Bone Growth | Bone forms in soft tissues, limiting movement | Early therapy helps; sometimes surgery needed |
Non-Healing or Misalignment | Broken bone doesn’t heal right | Close follow-up; possible additional surgery |
Infection or Wound Issues | Redness, swelling, pain, or drainage | Sterile surgery, antibiotics, and careful wound care |
Arthritis Later On | Wear & tear in the joint over time | Regular check-ups and joint-friendly lifestyle choices |
What to Expect & How to Help Your Recovery
- Healing time: 6 months to 2 years for full strength and motion recovery.
- Typical motion range:
- Flexing (~30°) to nearly straight (~130°).
- Assistive care: Physical therapy is vital—don’t skip appointments!
- Safety first: Use a reacher, open packages carefully, avoid sudden impact falls.
- Bone health: Adequate diet, vitamin D, and low-impact exercises like walking will help prevent future fractures.
Frequently Asked Questions
Can I live normally after this injury?
Yes! Most patients regain good arm function and return to daily activities, especially with proper surgery and rehab.
When can I drive again?
Driving can resume when your elbow is pain-free and functional—usually several weeks post-injury, with approval from your care team.
What about sports or heavy lifting?
Avoid heavy lifting for about 3 months. High-risk sports might need to wait several months longer—your surgeon will advise you.
What signs should I watch for?
Call your doctor immediately if you notice increased pain, redness, swelling, numbness, inability to move fingers, or fever.
In Summary
- These fractures are serious but treatable.
- Surgery and early rehab are key to recovery.
- Follow-up care and bone health are essential for long-term success.
- Support and patience—with realistic expectations, most patients do very well.
“Early movement and follow-through with therapy are the most important things you can do to avoid stiffness and get back to your usual routine.”
Resources
- Home Exercise Guide — A picture-based handbook to help you improve motion safely.
- Support Services — Ask about community rehab, transportation support, or recovery check-in visits.
Need Help?
- Questions for your care team?
- Ask about wound care, activity restrictions, and therapy schedules.
- Important: Always follow your surgeon’s instructions for the best outcome.
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025