Upper Arm Fractures
(Proximal Humeral Fractures; Shoulder Fractures)
-
Upper arm fractures usually result from a fall on an outstretched arm.
-
Usually, the broken pieces of bone remain in place or close together and thus tend to heal on their own.
-
These fracture cause pain and swelling in the shoulder and upper arm and limit movement of the arm.
-
Doctors diagnose upper arm fractures based on x-rays and sometimes computed tomography.
-
Usually, only a sling, sometimes with a swathe, is required, but sometimes surgery is needed to realign the broken bones or to replace the joint.
(See also Overview of Fractures.)
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 or move only slightly out of place and thus tend to heal on their own.
Upper arm fractures are common among older people.
Symptoms
Diagnosis
(See also Diagnosis of Fractures.)
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.
Doctors take x-rays of the shoulder joint from different angles to determine whether it is fractured.
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.
Treatment
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).
Sometimes the shoulder joint must be replaced.
