Humerus Fractures
What are they?
Humerus fractures are fractures of the humerus, the bone of the upper arm.
How do they occur?
Most humerus fractures result from falls, but motor vehicle accidents, sports and direct trauma can also cause them. Fractures can involve any part of the humerus. Distal humerus fractures are fractures of the humerus near the elbow, and include fractures that extend into the joint. Other fractures involve the shaft, or middle part of the bone. Proximal humerus fractures are fractures of the humerus near the shoulder joint.
How are they treated?
The initial management of fractures involves obtaining xrays of the humerus. Xrays of the elbow or shoulder may be necessary. Splinting with or without reduction maneuver and sling treatment of the extremity is initially performed to improve alignment, stablilize the injury, improve pain, and prevent further injury. An assessment of the function of nerves and blood flow to the extremity is important at this time. The orthopedic surgeon assesses the xrays, and in consideration of patient characteristics including their age, comorbidities, nerve function, and functional status, determines the appropriate treatment for the fracture. Injuries will typically benefit from therapy to maximize functional outcome.
Proximal humerus fracture: Many proximal humerus fractures can be treated without surgery. The arm is immobilized in a sling and range of motion exercises are commenced once sufficient healing has taken place. At times, the surgeon determines that surgery is necessary. The two most common surgeries involve 1) either fixing the fracture with hardware such as plates and screws, or 2) performing a shoulder replacement.
Humerus shaft fracture: Many humeral shaft fractures can be treated without surgery with the expectation of a high rate of union and satisfactory function. Usually a functional brace is applied to the arm for about 12 weeks or until sufficient healing has taken place. If the surgeon determines surgery to be necessary, fixation is accomplished usually with the use of plates and screws or a rod within the medullary cavity of the bone.
Distal humerus fracture: If distal humerus fractures are non- or minimally displaced, they may be amenable to conservative treatment. Most distal humerus fractures will benefit from surgery for reduction and internal fixation, typically via plates and screws. When fractures are not easily reconstructible, and the patients are elderly, elbow replacement surgery, instead of fixation of the fractures, can give reliable and functional results.
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