A humeral fracture is a fracture of the upper arm and can occur in the upper, central or lower part of the bone.
The upper area includes the anatomical neck, surgical neck, trochanter and humeral head.
In general, an upper arm fracture occurs in elderly people suffering from osteoporosis when they fall or slip and fall on their hands.
If the fracture of the humerus occurs in the upper area, it can also be accompanied by shoulder dislocation, which worsens the clinical picture.
The lesion of the humerus bone shaft (the central area, technical diaphysis) mainly affects adults and the cause of the fracture is usually a direct trauma.
Fractures of the upper part of the elbow occur almost exclusively in children and adolescents when they fall with overstretched elbow.
Often fractures in newborns and children are greenwood fractures, that is, a crack forms in the bone, but the outer sheath (periosteum) remains intact because the composition of the bone is different.
What are the signs and symptoms of an upper arm fracture?
The patient appears in the emergency room with his arm nestled against the chest and his elbow bent, due to the fear of the pain, which is very strong.
The signs are:
- swollen arm;
- Hematoma that extends over the inside of the arm and chest.
The arm cannot be moved and you can hear a sound of bones “rubbing” against each other.
If it is an open fracture, part of the bone can be seen protruding through the skin.
The fracture of the right upper arm is more serious, as it prevents the performance of many everyday activities. However, if the patient is left-handed, the fracture of the left arm leads to greater disability.
What are the complications of upper arm fracture?
An immediate complication is hypovolemic shock, that is, a drastic decrease in circulating blood that can lead to fainting.
Attention must be paid to the possible development of thrombophlebitis, i.e. the formation of blood clots that occlude the arteries.
Thrombi can cause embolisms in which these coaguls detach, enter the circulation and can occlude arteries in the body.
Fractures associated with a higher risk are higher, near the shoulder blade and collarbone, while an injury at the level of the elbow carries fewer risks.
Complications of trauma include injuries to nerves, muscles, and arteries.
Along the diaphysis of the humerus run the nerves: radialis, medianus and ulnaris, which can suffer a strain or injury if a fracture is displaced.
arteries can be severely damaged; with a fracture of the anatomical neck of the humerus, they can cause vascular necrosis, that is, an interruption of blood circulation in a region of the body. Where there is no blood, there is no life. The most commonly affected artery is the brachial artery.
A displaced fracture can cause shoulder dislocation, tearing of the tendons of the rotator cuff or arm muscles: biceps, brachialis, triceps and deltoid muscle.
Among the complications that occur late, there is the formation of pseudarthrosis, when the bone does not consolidate properly or a fibrous callus forms instead of the bone callus.
What is the prognosis for an upper arm fracture?
The recovery time depends on the type of fracture. If it is undisplaced, it can heal completely in 2-3 months. However, if it is a displaced fracture with many fragments, surgical intervention may be required.
In this case, the orthopedist uses a plate or endoprosthesis to hold the fragments together.
If it is an elderly patient, a complete restoration of freedom of movement is not always possible and the broken arm may no longer be able to be moved like a healthy one.
It takes a few months for a displaced fracture to restore the same mobility as before the trauma, especially until you are able to turn the shoulder properly again.
First aid for an upper arm fracture
The elbow must be bent at right angles and the forearm must be supported with a scarf tied behind the neck.
In the case of an open and bleeding fracture, it is necessary to bandage the arm to avoid major blood loss.
You have to call the ambulance immediately. If this is not possible, a splint must be tied to the arm to immobilize the bone fragments.
What to do? Which therapy is suitable for a humeral fracture?
The orthopedist may recommend surgery to prevent severe damage or to restore mobility. Subsequently, rehabilitation is necessary to fully recover.
In the case of an undisplaced fracture, an orthosis or a plaster cast secured to the neck must be worn for about a month to allow the bone to be consolidated.
The best therapy to support bone consolidation is magnetic therapy, which can cut recovery time in half.
If the plaster cast is removed, an X-ray is taken for control. If the orthopedist considers that the process of callus formation has begun and there is no risk of pseudarthrosis, he recommends a few sessions of physiotherapy to regain muscle strength, mobility and coordination.
Possible consequences are:
- poor consolidation (rare);
- Functional impairment (common), especially older people can not regain full mobility, especially when lifting the arm.