Our elbows endure considerable daily wear and tear. They are complex hinged joints made up of three bones (humerus, ulna, and radius). The bones in the elbow are held together with ligaments. The ends of the bones are covered with cartilage, which has a rubbery consistency that absorbs shock and allows the joints to slide against one another.
One of the most common, and serious elbow injuries is a fracture of the distal humerus bone – typically the result of a fall on the elbow with the arm in a flexed position. There are two types of distal humerus fractures: Those involving the joint surface (intra-articular fractures) and those not involving the joint surface (extra-articular fractures).
In this article Detroit area board certified hand surgeon Dr. Uzma Rehman discusses how elbow fractures of the distal humerus are treated.
Surgery for Distal Humerus Elbow Fractures in Children
The treatment of distal humerus elbow fractures in children is different than treatment in adults. In most elbow factures in kids, the bone is unstable and requires some type of internal fixation to prevent it from healing in an incorrect position.
Elbow fractures in children and commonly are caused by falling off of monkey bars. Unlike elbow fractures in adults, children’s elbow fractures are typically a hyper-extension injury – which is when a joint is forced to move beyond its normal range of motion.
Children’s distal humerus elbow fractures are usually characterized by an obvious, visible deformity of the arm in addition to rapid swelling. Treatment usually includes the surgeon aligning the bones properly under x-ray, while holding them in place with pins placed through the skin into the bone.
Most children who undergo distal humerus elbow fracture surgery stay overnight in the hospital and are discharged the next day. The stabilizing pins are generally removed by the surgeon after 4 weeks and the cast is taken off after about 6 weeks.
Surgery for Distal Humerus Elbow Fractures in Adults
Distal humerus elbow fractures in adults almost always require surgical repair – but a small percentage can be treated with just a long arm cast. The downside, however, to treating with a cast is that the prolonged elbow immobilization can result in significant and sometimes permanent stiffness in the elbow. T
Distal humerus elbow fractures in adults typically involve the surface of the joint (cartilage). It is very important to ensure that the surface of the cartilage is repaired as accurately as possible in order to avoid long term mobility issues and/or the development of arthritis.
Adult distal humerus elbow fracture surgery involves re-aligning the fracture and holding the repair in place with plates and screws. This elbow repair surgery takes approximately 2 hours and most adult patients stay overnight in the hospital.
Adult patients wear a splint (soft cast) for a short period of time after surgery, and then begin an aggressive physical therapy regimen to regain range of motion in the elbow. Total recovery time after distal humerus elbow fracture surgery can take 6 months.
After surgical repair, patients are able to begin moving their arm within 2 weeks of the surgery and the risk of long-term stiffness is reduced. Most adult patients have very good range of motion and strength after the bone completely heals.
A dynamic elbow splint called a “dynasplint” may be used to apply gentle force that straightens or bends the elbow. The degree and amount of force can be progressively adjusted to their own tolerance.
Surgery to remove the plates and screws is far less invasive than the fracture repair itself – and is usually offered around 12 months after the initial surgery. Most patients fully recover from the hardware removal surgery in about a month to six weeks.
Detroit Area Elbow Surgeon
If you believe you or your child may have suffered a distal humerus elbow fracture, immediate medical intervention is required to avoid long term complications, deformity and loss of mobility.
Board certified Detroit area elbow surgeon Doctor Rehman has the experience, advanced resources, and compassion to perform your distal humerus elbow fracture surgery. Contact her office immediately if you are looking for a surgeon in the Detroit area to repair a fractured elbow, arm, hand or fingers.