Initial evaluation includes a medical history, physical examination, x-rays and
specialized testing. Testing should include evaluation of pulse, nerve function,
swelling and skin integrity. Care should be taken to ensure that there are no fragments
that puncture the skin as this can lead to increased risk of infection. In case
of complex fractures a CT scan is needed.
Initial treatment after evaluation includes the placement of a splint to the elbow,
a sling to keep the elbow in position, ice and pain medication. Often distal humerus
fractures require surgical fixation if there is displacement of the fragments. Surgical
fixation is done with realignment of the bones and a placement of plates and screws
to hold the alignment. This may be done either as an outpatient or as an overnight
stay surgery. Typically physical therapy is started a few days to weeks after the
injury depending on the extent of injury. Restrictions from lifting objects typically
last 6 to 12 weeks.