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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