Johns Hopkins Medicine. Fractures of the humerus can occur proximally, in the shaft (diaphysis), or distally. [2], The cause of a humerus fracture is usually physical trauma such as a fall. [7], Definitive diagnosis of humerus fractures is typically made through radiographic imaging. [13][14][3] Fractures of the humerus shaft are subdivided into transverse fractures, spiral fractures, "butterfly" fractures, which are a combination of transverse and spiral fractures, and pathological fractures, which are fractures caused by medical conditions. Statistically, about 3% of all broken bones constitute this type of fracture. Types of surgical procedures include: Healing of a mid-shaft humerus fracture with non-surgical treatment generally takes ten to twelve weeks. [2] Complications may include injury to an artery or nerve, and compartment syndrome. There are several types of humerus fractures, depending on the location … They are classified according to their location as proximal, humeral shaft, or distal fractures. doi:10.1590/S1413-78522012000400006, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Click below and just hit send! A mid-shaft humerus fracture is a type of broken arm. The majority of both proximal and midshaft humeral fractures are nondisplaced and can be treated conservatively (ie, nonsurgically). 18% of humerus fractures include radial nerve damage. Shao YC, Harwood P, Grotz MR, Limb D, Giannoudis PV. [2] Many humerus shaft fractures may be treated with a brace rather than surgery. National Center for Biotechnology Information, StatPearls. [2] Types include proximal humeral fractures, humeral shaft fractures, and distal humeral fractures. A Broken Arm is also called a Midshaft Humerus Fracture (the arm bone is called the humerus and the break occurs in the middle portion of the bone). Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. [2], After a humerus fracture, pain is immediate, enduring, and exacerbated with the slightest movements. Q&A: Diagnosis of Nerve Damage in Mid-Shaft Humeral Fracture Last edited October 04, 2010. [9] Less frequently, proximal fractures occur from motor vehicle accidents, gunshots, and violent muscle contractions from an electric shock or seizure. 2014;37(3):e307–e312. doi:10.5435/JAAOS-20-07-423. [5], Distal humerus fractures usually occur as a result of physical trauma to the elbow region. Radial Nerve Injury. [6][4] If the fracture affects the blood supply, then the patient will have a diminished pulse at the wrist. [9] Fractures of the humerus shaft are usually correctly identified with radiographic images taken from the AP and lateral viewpoints. Falls that produce humerus fractures among the elderly are usually accompanied by a preexisting risk factor for bone fracture, such as osteoporosis, a low bone density, or vitamin B deficiency. One of the complications of fractures is radial nerve palsy. It also includes the hinge of the elbow joint on the bottom. Most radial nerve injuries typically improve with time, but your doctor should follow up with you in case further treatment is needed. An advantage of the fracture brace is that as healing progresses, you can begin to use your shoulder and elbow.. A humeral hemiarthroplasty may be required in proximal cases in which the blood supply to the region is compromised. The most common cause of a humeral shaft fracture is a fall, but high-energy injuries (motor vehicle collisions, sports injuries) and penetrating trauma (gunshot wounds) also can cause this injury. Many humeral shaft fractures, especially in older people, occur as a result of the weakening of the bone from osteoporosis.. [2], Treatment options may include a sling, splint, brace, or surgery. Most humerus fractures do not require surgical intervention. Because these tendons are important to shoulder motion, treatment may depend on the position of these tendo… Some people with this kind of fracture say it feels like their arm isn't attached. [16], Fractures of the humerus shaft are most often uncomplicated, closed fractures that require nothing more than pain medicine and wearing a cast or sling. Physical exam. There may be a decreased ability to move the arm and the person may present holding their elbow. One-part fractures involve no displacement of any parts of the humerus, two-part fractures have one part displaced relative to the other three; three-part fractures have two displaced fragments, and four-part fractures have all fragments displaced from each other. Am J Surg. J Am Acad Orthop Surg. [2] Surgical options may include open reduction and internal fixation, closed reduction and percutaneous pinning, and intramedullary nailing. [1][2] Diagnosis is generally confirmed by X-rays. Interestingly, one of the most common reasons for nonunion is surgery . If the elbow is bent during the trauma, then the olecranon is driven upward, producing a T- or Y-shaped fracture or displacing one of the condyles. [11] Severe fractures often cause long-term loss of physical ability. 1 The radial nerve can be injured at the time of the fracture or during treatment. Symptoms. It's especially strong and is capped with the ball of the ball-and-socket shoulder joint. The humerus is the bone in your upper arm, between your shoulder and elbow. Humeral shaft fractures account for 3-5% of all fractures 1,3. Radial nerve injuries cause: Numbness on … This type of fracture occurs in people of all ages and can occur after a traumatic event, like a high speed motor vehicle accident, or after a simple slip and fall. J Bone Joint Surg Br. The fracture is typically accompanied by a discoloration of the skin at the site of the fracture. Holstein-Lewis fracture. pain. [23] Middle fractures are also common among the elderly, but they frequently occur among physically active young adult men who experience physical trauma to the humerus. Usually, the fracture is treated in a splint or sling for a week to allow swelling to subside, and then you're fitted with a fracture brace. Effects of Smoking Cigarettes on Musculoskeletal Health, What to Do When You Tear Your Biceps Tendon at the Elbow Joint, Common Fractures of the Arm, Elbow, and Wrist That Your PT Can Treat, Causes and Treatment of a Femur Fracture (Broken Thigh Bone), Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting, Failure to heal with nonsurgical treatment (, Difficulty straightening (extending) the wrist and fingers. [3] Incidence of proximal fractures increases with age, with about 75% of cases occurring among people over the age of 60. National Center for Biotechnology Information, StatPearls. There are three locations that humerus fractures occur: at the proximal location, which is the top of the humerus near the shoulder, in the middle, which is at the shaft of the humerus, and the distal location, which is the bottom of the humerus near the elbow. Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. Complex fracture patterns pose greater challenges for treatment. Mid-shaft humerus fractures. Nonunion is a difficult problem and occurs when the fracture doesn't heal. [21] Complications in the recovery process of severe fractures include osteonecrosis, malunion or nonunion of the fracture, stiffness, and rotator cuff dysfunction, which require additional intervention in order for the people to fully recover. These fractures may involve the insertion of the important rotator cuff tendons. Penetrating trauma (gunshot wounds) can also cause this injury. A humerus fracture is a break in the large bone of your upper arm. The affected region swells, with bruising appearing a day or two after the fracture. Ayotunde OA, Sunday OK, Oluwatoyin A, Dare OJ. [21], Humerus fractures are among the most common of fractures. When Is Surgery Necessary for a Broken Collarbone? Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting. Specifically, the radial nerve is often … [7], closed reduction and percutaneous pinning, "Interventions for treating proximal humeral fractures in adults", https://en.wikipedia.org/w/index.php?title=Humerus_fracture&oldid=987306299, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Generally good (proximal and shaft), Less good (distal), This page was last edited on 6 November 2020, at 05:08.
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