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Humerus fractures are common. The humerus is the long bone in your upper arm. A fracture is a broken bone. The humerus is most frequently fractured as the result of a fall or motor vehicle crash. Depending on the location and severity of the fracture, some bones may heal without surgery. Fractures that are very unstable are realigned and held in place with surgical hardware. Physical rehabilitation usually follows either form of treatment and is an important part of recovery to regain use of the shoulder and upper arm.
The humerus is the long bone that connects your shoulder to your elbow. The head of the humerus (proximal humerus) is attached to the shoulder by the rotator cuff muscles. The long part of the bone is called the shaft. The distal humerus is the end of the bone that connects with the forearm to form the elbow.
Trauma is the main cause of humerus fractures. Most injuries result from a direct impact to the body, such as during a fall or motor vehicle crash. Older adults may experience humerus fractures from relatively minor falls.
There are different types of humerus fractures. They are named for the area of the bone that is broken. Proximal humerus fractures occur near the shoulder. Mid-shaft fractures are located in the middle of the bone. Distal humerus fractures are located near the elbow joint and are more common in children than in adults.
Humerus fractures cause severe pain and swelling. It may be very difficult for you to move your upper arm. If the nerves are affected, you may experience unusual sensations in the hand and weakness in your hand and wrist.
Your doctor can diagnose a fractured humerus by examining your arm and taking X-rays. In rare cases, more sophisticated imagery, such as a computed tomography scan is used to provide a more detailed view.
If the fractured bones are still in their proper position, a sling can be used to support and keep the arm from moving while it heals. Most mid-shaft humerus fractures can heal with immobilization and usually do not require surgery. Casting is not commonly used.
Your doctor will determine when you can begin physical therapy. Your therapists will help you move your shoulder joint at first with passive range of motion exercises. These exercises help improve circulation and reduce stiffness. You will proceed to more advanced exercises to increase strength and motion.
If the fractured bones have moved out of position, surgery is recommended. Surgery called an Open Reduction and Internal Fixation (ORIF) is used to realign the bones and secure them in position with surgical hardware, such as plates, pins, screws, and wires. Surgery is most frequently used for proximal and distal humerus fractures.
For severe proximal humerus fractures, a shoulder replacement surgery is used to remove the damaged bone and insert an artificial implant. Severe proximal humerus fractures may also require reattachment of the shoulder muscles (rotator cuff muscles). Rehabilitation therapy, as described above, begins as soon as possible.
The recovery process is different for everyone, depending on the severity of the injury and the treatment you received. Most fractures heal in about 4 to 6 weeks, but severe injuries may take longer to heal. Your doctor will let you know what to expect.