Arm Bone Fractures (Distal Humerus Fractures): Fixation With a Plate and Screws

Arm Bone Fractures (Distal Humerus Fractures): Fixation With a Plate and Screws

This surgical video demonstrates the repair of an arm bone fracture, also called a distal humerus, fracture with a plate and screws. Here, we see a left elbow. On the operating table, the patient is lying on their right side, and the left arm is bent and supported by an arm holder. Here is the end of the upper arm bone, or humerus. The surgeon has already made an incision and cleared away soft tissue from the elbow joint. In this demonstration, more soft tissue has been cleared away than what is normally done in the operating room, so that we can better see the bones. There is also no fracture in this arm bone.

Viewing from the side, the appropriately sized plate has been selected, placed over the inside part of the arm bone, and temporarily secured with a ball headed pin. Next, in the middle of the plate, the surgeon uses a drill guide to prepare a hole in the bone for a screw. A screw of the correct length is inserted through the hole in the plate. The surgeon moves to the end of the plate, drills a hole, and measures the length, and inserts another screw. X-rays are taken to confirm correct alignment of the plate. Then the surgeon continues to drill, measure, and insert screws until the plate is secure against the bone. A final x-ray is taken to confirm the alignment of the plates and screws. The incision will be closed and the surgery is complete.