The fracture involving lower end of the arm bone (distal humerus) is often the result of high energy injury such as fall from height or motor vehicle accident. This causes pain, swelling and inability to use the elbow which in turn affects the overall function of the upper limb. Your surgeon will initially immobilize the elbow in a plaster for pain relief. This fracture usually needs surgery except in very elderly people with low functional demand where it can be managed without surgery (bag of bone technique). Most of the time, the fracture can be fixed (ORIF) using plate and screwwith successful union of the fracture, however, your surgeon may consider replacement surgery (either hemiarthroplasty or a total elbow replacement) in case of very complex fracture which are difficult for fixation.