Fifty-nine-year-old woman with isolated metastasis from renal cell carcinoma was treated initially at outside facility with radiation, curettage, and cementation for pathologic distal humeral fracture. A, Anteroposterior radiograph shows failure of construct. B, Tongue of triceps tendon is reflected distally. C, Distal humerus is resected, and ulna is prepared to receive prosthesis. D, Resected distal humerus and prosthesis. E, Prosthesis cemented into humerus and ulna. F, Triceps repaired. G and H, Anteroposterior and lateral postoperative radiographs.