Introduction
Humerus fractures are prevalent injuries affecting the upper arm's long bone, known as the humerus. These fractures often occur due to falls or vehicle accidents. Depending on the fracture's location and severity, some may heal without surgical intervention, while more unstable fractures may require surgical realignment and stabilization using specialized hardware. Physical rehabilitation is essential following either treatment to restore functionality to the shoulder and upper arm.
Anatomy
The humerus is the long bone that spans from the shoulder to the elbow. Its upper section, known as the proximal humerus, connects to the shoulder through the rotator cuff muscles. The central part of the humerus is referred to as the shaft, while the distal humerus, located at the elbow end, forms the joint with the forearm.
Causes
The primary cause of humerus fractures is trauma, often resulting from direct impacts like falls or vehicle collisions. Older adults are particularly susceptible, experiencing fractures even from minor falls. Humerus fractures are classified based on their location: proximal humerus fractures are near the shoulder, mid-shaft fractures occur along the bone's length, and distal humerus fractures are closer to the elbow, more commonly seen in children than adults.
Symptoms
Individuals with a fractured humerus typically experience intense pain and swelling, with significant difficulty moving the upper arm. If the fracture affects nearby nerves, unusual sensations in the hand and weakness in the hand and wrist may also occur.
Diagnosis
A healthcare provider can identify a humerus fracture through physical examination and X-rays. In rare cases, advanced imaging techniques like computed tomography (CT) scans may be employed for a more detailed assessment.
Treatment
When the fractured bones remain aligned, a supportive sling can be used to restrict movement while healing. Most mid-shaft fractures heal effectively through immobilization without the need for casting or surgery. Your doctor will guide you on when to start physical therapy, which begins with passive range of motion exercises to enhance circulation and alleviate stiffness, progressing to more intensive strength and mobility exercises.
Surgery
Surgical intervention is necessary if the bone fragments are misaligned. Open Reduction and Internal Fixation (ORIF) surgery is commonly performed to realign the bones and secure them with hardware such as plates, pins, and screws. This approach is particularly relevant for proximal and distal humerus fractures. For severe proximal fractures, a shoulder replacement may be indicated, involving the removal of the damaged bone and insertion of an artificial joint, possibly requiring reattachment of the rotator cuff muscles. Rehabilitation therapy commences as soon as possible post-surgery.
Recovery
Recovery from a humerus fracture varies among individuals, influenced by the injury's severity and treatment type. While most fractures heal within 4 to 6 weeks, more serious injuries may require additional time for complete healing. Your healthcare provider will provide specific expectations regarding your recovery process.
