Distal humeral fractures are caused by direct trauma to the arm or elbow and by axial loading transmitted through the elbow. Most common causes are:
Traumatic event (eg. motor vehicle, bicycle accidents)
Fall with the outstretched arm where the ulna pushes towards the humerus
Fall on the flexed elbow
Direct impact with a hard object (hockey/baseball bat, car parts during a collision)
Pathological fractures due to osteoporosis or cancerous metastatic growth.