Does this make sense to you? Mother fell and broke her elbow (the bottom of the long arm bone, not her forearm bone). They want to wait before they do surgery. They say there’s a chance she could heal on her own with a splint if she’s careful. What if it doesn’t heal? Will the surgery still works as good as if she had it now? We just don’t know what to think.

Fractures of the humerus (upper arm bone) just above the elbow are difficult to treat. Surgery is the standard way to treat these fractures. But the optimal approach isn’t always clear at the out set. The surgeon must take into consideration many factors. How did it happen? What kind of break is involved? Are the soft tissues around the bone damaged in any way? Did the elbow joint surface crack in the process? How strong is the bone (i.e., does the patient have osteoporosis or brittle bones)?

Surgeons are seeing more of these injuries with the aging adult population in America. Most of these fractures occur in older adults with poor bone quality. That’s one of the things that really makes surgery so difficult. Conservative (nonoperative) care is possible but only when the fracture is stable and can be immobilized in a cast or splint. That type of fracture isn’t as common as the displaced (bones separate), comminuted (many tiny bone fragments) fractures that require surgery.

It’s true that delaying surgical treatment can compromise the results. But surgery comes with its own unique risks and potential problems and complications. If the surgeon thinks the arm is stable enough and your mother is savvy enough (mentally alert and compliant) to keep from disrupting the healing bone, then she will be spared the trauma of major surgery. If she is not an overly active individual and she is willing to follow the surgeon’s instructions about keeping the arm immobile, she should have a good-to-excellent result.