Distal humeral extraarticular fractures are best treated with surgery in order to avoid deformity close to the elbow joint.
Extraarticular means that the fracture does not involve the elbow joint directly. Proximal is used to describe the near end of the bone. Distal is used to describe the far end of the bone.
This patient was in his 20's, injury was sustained from a severe fall.
The sketch below is my presurgical plan.
Plate was applied posterolaterally, under radial nerve.
Here are a couple of the views of the operation. The picture below was taken just before closing the wound. In this picture you see the back of the arm and the triceps on the top half of the picture. The steel plate is in the middle of the picture, between the triceps above and the humerus below.
Here is the radial nerve going over the plate.
Xrays in 2 and a half months show a healed fracture.
No cast was used. Motion of the elbow was started immediately. Patient was told to not lift anything with the injured arm, but to otherwise move it to tolerance. Physical therapy was started in the first week.
By 2 months, patient had regained full motion, no difference side to side. At 1 year after surgery he remained asymptomatic, at which point he was discharged from care.
Video of the fluid and pain-free motion.