Upper Arm Fractures
(Proximal Humeral Fractures; Shoulder Fractures)
Upper arm fractures occur at the upper end of the upper arm bone (humerus), affecting the shoulder joint.
Upper arm fractures usually result from a fall on an outstretched arm. Sometimes they result from a direct blow. Usually, the broken pieces of bone do not move out of place and thus tend to heal on their own.
Upper arm fractures are common among older people.
If people think they may have fractured their upper arm, they should see a doctor as soon as possible.
Doctors ask people to describe what happened and what their symptoms are. Doctors also examine the elbow and collarbone (see Overview of Fractures, Dislocations, and Sprains : Diagnosis).
Doctors take x-rays of the shoulder joint from different angles to determine whether it is fractured. They may gently move the joint. Moving the joint can help doctors determine the severity of the injury and whether it is dislocated, fractured, or both.
Sometimes, if x-rays are unclear, computed tomography (CT) is done. CT combines x-rays with computer technology to produce a more detailed, three-dimensional image of the injured area.
Most upper arm fractures are treated with a sling, sometimes held in place by a piece of cloth or strap (called a swathe—see Figure: Commonly Used Techniques for Immobilizing a Joint).
Exercises to move the shoulder joint through its full range of motion, such as Codman exercises, are started as soon as possible because this joint is prone to becoming permanently stiff, especially in older people.
If bone is broken into several pieces, people are referred to an orthopedic surgeon, who aligns the broken pieces and inserts metal plates, screws, and wires to hold the bone together (called open reduction with internal fixation, or ORIF—see Surgery).
Sometimes the shoulder joint must be replaced.