Dr. Mohinder Mital: An 81-year-old widow arrived in the emergency ward of the Massachusetts General Hospital with a chief complaint of pain in the right arm. She described a fall down one flight of stairs approximately one hour before admission. There was no loss of consciousness preceding or following the injury.
Her past medical history included fractures of the mid shafts of the right radius and ulna nine years earlier. These had been treated by open reduction with Rush rod fixation of the ulna and iliac crest bone graft fixation of the radius, held in position by four stainless steel screws. A clinic note one year after this injury described no symptoms and a full range of flexion and extension of the elbow with 30° pronation and 50° supination in the forearm.
Physical examination revealed an alert, elderly, obese woman. She was complaining bitterly of pain in the right arm.
Aufranc OE, Jones WN, Bierbaum BE. Open, Comminuted Fracture of the Distal Humerus. JAMA. 1968;204(5):387–391. doi:10.1001/jama.1968.03140180037010
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