You are here

Distal Humerus Fracture S42.409A 812.40

distal humerus fracture xray

elbow anatomy picutre

elbow cross sectional anatomy

elbow approach picture

distal humerus fracture ORIF xray

synonyms: supracondylar humerus fracture, intercondylar humerus fracture, T condylar humerus fracture, transcondylar humerus fracture, Y condylar humerus fracture, distal humerus fracture

Distal Humerus Fracture ICD-10

Distal Humerus Fracture ICD-9

  • 812.40 (fracture of humerus, lower end, unspecified, closed)
  • 812.41 (fracture of humerus, supracondylar, closed)
  • 812.51 (fracture of humerus, supracondylar, open)
  • 812.50 (fracture of humerus, lower end, unspecified, open)

Distal Humerus Fracture CPT

Distal Humerus Fracture Etiology / Epidemiology / Natural History

  • Generally from a fall onto the posterior elbow, fall onto outstretched hand, or MVA.
  • Bimodal distribution: patients in second decade with high-energy trauma and elderly patients with low-energy falls.

Distal Humerus Fracture Anatomy

  • Distal humerus is composed of a medial and lateral columns separated by the trochlea.
  • Medial column diverges from the humeral shaft at @45º angle.
  • Lateral Column diverges from the humeral shaft at @20º angle.
  • Trochlea has a 300º arch of cartilage.
  • see also Elbow Anatomy.

Distal Humerus Fracture Clinical Evaluation

Distal Humerus Fracture Xray / Diagnositc Tests

  • A/P, lateral and oblique views of the elbow demonstrate fracture.
  • CT scan: typically indicated do to complexity of most distal humerus fractures. 3D reconstructions with radius and ulna subtracted are beneficial.

Distal Humerus Fracture Classification / Treatment

Distal Humerus Fracture Associated Injuries / Differential Diagnosis

Distal Humerus Fracture Complications

  • Superficial wound infection
  • contracture
  • Nonunion
  • Hardware failure
  • Malunion
  • Painful hardware
  • Ulnar nerve palsy
  • Radial nerve palsy
  • Heterotopic ossification

Distal Humerus Fracture Follow-up Care

  • Post-op: Posterior splint, NWB.
  • 7-10 Days: Remove splint, begin passive shoulder and elbow ROM. Stress elbow ROM. Active flexion, gravity extension.  Active extension avoided for 6wks. Generally start physical therapy for ROM and strengthening
  • 6 Weeks: Begin active extension, strengthening exercises provided fracture union is evident on xray.
  • 3 Months: Ensure full restoration of shoulder and elbow ROM. Consider bone stimulator if union is delayed. Sport specific rehab.
  • 6 Months: return to full activities / sport.
  • 1Yr: Follow-up xrays, assess outcomes.
  • Outcome after ORIF of intra-articular Fracture’s= Mean flexion contracture-25 degress, mean arc of motion-108 degrees, @75% of normal strength.  24% reoperation usually for HWR (McKee JBJS 2000;82A:1701).
  • Elbow Outcome Measures.

Distal Humerus Fracture Review References

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer