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DISTAL HUMERUS FRACTURE

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A distal humerus fracture occurs when there is a break anywhere within the distal region (lower end) of the humerus. The bone can crack just slightly or break into many pieces (comminuted fracture). The broken pieces of bone may line up straight or may be far out of place (displaced fracture).

In some cases, the bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the bone. This is called an open fracture. Open fractures are particularly serious because, once the skin is broken, infection in both the wound and the bone is more likely to occur. Immediate treatment is required to prevent infection.

Distal humerus fractures are uncommon; they account for just about 2 percent of all adult fractures. They can occur on their own, with no other injuries, but can also be a part of a more complex elbow injury.

DISTAL HUMERUS ANATOMY

DISEASE EXPLAINED

SYMPTOMS

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)

CAUSES

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. In this situation, the ulna (one of the forearm bones) is driven into the distal humerus and this causes it to break.

Distal humerus fractures are also sometimes caused by weak bone. This is most common in older patients whose bones have become weakened by osteoporosis. In these patients, a fracture may occur even after a minor fall.

TREATMENT OPTIONS

TREATMENT OPTIONS

Treating a humerus fracture depends on several factors, including the type of fracture and whether there are any loose bone fragments. To determine the best treatment, your doctor will start by taking an X-ray of your arm. They may also have you do some movements with your arm. This will help them determine what kind of fracture you have and whether you have any other injuries.

In many cases, proximal and mid-shaft humerus fractures don’t require surgery because the broken ends usually stay close together. This makes it easier for your humerus to heal on its own. However, you’ll still need to wear a sling, brace, or splint to keep your arm from moving and stabilize your shoulder, if needed. Occasionally, surgery is required with either plates, screws, rods, or sometimes replacement of your shoulder joint with use of a prosthesis.

Distal fractures and more severe proximal or mid-shaft fractures usually require surgery. There are two main approaches that your surgeon may use:

Pins and screws. If you have an open fracture, which involves a piece of bone sticking through your skin, surgery will be required to clean up the broken ends and they may use pins and screws and plates to hold the broken ends of your humerus in place.
Bone grafting. If some of the bone has been lost or severely crushed, your surgeon may take a piece of bone from another area of your body or a donor and add it to your humerus. In some cases, doctors can even use an artificial material to create a new piece of bone.
Regardless of whether or not you need surgery, your doctor will probably suggest following up with physical therapy. This will help you learn exercises and movements you can do to help strengthen your arm muscles and regain your range of motion.

CONTACTING DR. PERLMUTTER

Texting is preferred by Dr. Perlmutter for communication (717-836-6833). Please contact him ASAP, should you have any concerns whatsoever. Many patients fail to contact Dr. Perlmutter when they should have because they are "afraid of bothering him." This is a potentially dangerous attitude and Dr. Perlmutter will always welcome every opportunity to make his patients feel more comfortable. Please feel comfortable sending photographs to add perspective to your questions. Please turn on your flash, aim directly at the body part that you wish to show, and use an evenly colored, dark, and non-reflective background.

If you cannot text, you may call Dr. Perlmutter, however, you must use a confirmed caller ID unblocked telephone or he will not be able to return your call. If you need help turning off this feature you may:

1) Try pushing *82 prior to dialing, or

2) Use a different phone.

Your failure to do so will absolutely compromise your care and hurt your outcome!

If Dr. Perlmutter cannot be reached on his cell phone or by text, please contact the hospital operator to assist in reaching him or a member of his team. They can be reached at NASH: 252-962-8000. ECU Edgecombe: 252-641-7700.

IF YOU PERCEIVE AN EMERGENCY, PLEASE CALL 911 OR GO TO THE EMERGENCY ROOM ASAP.

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