The humerus is the long bone of your upper arm. There are many muscles, ligaments, and nerves found along the humerus. Humerus fractures are named based upon the location of their fracture. Fractures which occur close to shoulder joint, injuring the ball and socket are proximal humerus fractures. Fractures which occur to the middle portion are called mid-shaft fractures and those along the lower portion are distal humerus fractures. With proximal humerus fractures, the majority are treated with a sling for 2-3 weeks and then exercises to regain function of the arm. More severe injuries of the proximal humerus may require surgical measures.
Mid-shaft humerus fractures may occur during high impact accidents, such as motor vehicle collisions or sports-related injuries, resulting in possible radial nerve damage. If the radial nerve is damaged you may see a wrist in a drooped position, unable to actively bring the wrist upwards. Mid-shaft fractures are treated based upon the severity of the fracture. Fracture bracing is a common form of treatment for these injuries. The patient may be sent home with instructions for wearing the fracture brace and attending therapy. Therapy is designed to maintain range of motion in the shoulder while the humerus is healing.
Distal humerus fractures are more uncommon based upon the location, where the elbow meets the upper arm. These fractures often require surgical intervention to realign the joint properly. Secondary injuries may occur to the soft tissue surrounding the elbow joint. Elbow ligaments may be injured with these fractures due to the position of the elbow during the fall. Decreased elbow motion and ligamentous pain either on the inside or outside are the main complaints with distal humerus fractures. The patient may need a custom elbow orthotic to improve their range of motion.
The severity of the fracture determines the course of treatment. Typically soft tissue or nerve damage becomes a larger problem than the fracture itself. If there is a possibility of a radial nerve injury a custom or prefabricated orthotic is used for improving hand function and preventing further damage. Occupational therapy can assist in fabricating custom orthotics or providing information with which prefabricated brace to purchase.