Fractures of the humerus shaft are usually correctly identified with radiographic images taken from the AP and lateral viewpoints. For proximal fractures, X-rays can be taken from a scapular anteroposterior (AP) view, which takes an image of the front of the shoulder region from an angle, a scapular Y view, which takes an image of the back of the shoulder region from an angle, and an axillar lateral view, which has the patient lie on his or her back, lift the bottom half of the arm up to the side, and have an image taken of the axilla region underneath the shoulder. Diagnosis ĭefinitive diagnosis of humerus fractures is typically made through radiographic imaging. If the elbow is bent during the trauma, then the olecranon is driven upward, producing a T- or Y-shaped fracture or displacing one of the condyles. Distal ĭistal humerus fractures usually occur as a result of physical trauma to the elbow region. Long spiral fractures of the shaft that are present in children may indicate physical abuse. Metastatic breast cancer may also cause fractures in the humerus shaft. Physical trauma to the humerus shaft tends to produce transverse fractures whereas falls tend to produce spiral fractures. Middle fractures are usually caused by either physical trauma or falls. A stress fracture of the proximal and shaft regions can occur after an excessive amount of throwing, such as pitching in baseball. Other risk factors for proximal fractures include having a low bone mineral density, having impaired vision and balance, and tobacco smoking. Less frequently, proximal fractures occur from motor vehicle accidents, gunshots, and violent muscle contractions from an electric shock or seizure. Proximal humerus fractures most often occur among elderly people with osteoporosis who fall on an outstretched arm. Falls that produce humerus fractures among the elderly are usually accompanied by a preexisting risk factor for bone fracture, such as osteoporosis, a low bone density, or vitamin B deficiency. Humerus fractures usually occur after physical trauma, falls, excess physical stress, or pathological conditions. Distal fractures may also cause deformity, and they typically limit the ability to flex the elbow. Displaced fractures of the humerus shaft will often cause deformity and a shortening of the length of the upper arm. If the fracture affects the blood supply, then the patient will have a diminished pulse at the wrist. In cases in which the nerves are affected, then there will be a loss of control or sensation in the arm below the fracture. A crackling or rattling sound may also be present, caused by the fractured humerus pressing against itself. The fracture is typically accompanied by a discoloration of the skin at the site of the fracture. The affected region swells, with bruising appearing a day or two after the fracture. Signs and symptoms Īfter a humerus fracture, pain is immediate, enduring, and exacerbated with the slightest movements. Proximal and shaft fractures generally have a good outcome while outcomes with distal fractures can be less good. Surgical options may include open reduction and internal fixation, closed reduction and percutaneous pinning, and intramedullary nailing. Many humerus shaft fractures may be treated with a brace rather than surgery. In proximal fractures that remain well aligned, a sling is often sufficient. Treatment options may include a sling, splint, brace, or surgery. A CT scan may be done in proximal fractures to gather further details. Diagnosis is generally confirmed by X-rays. Types include proximal humeral fractures, humeral shaft fractures, and distal humeral fractures. Other causes include conditions such as cancer in the bone. The cause of a humerus fracture is usually physical trauma such as a fall. Complications may include injury to an artery or nerve, and compartment syndrome. There may be a decreased ability to move the arm and the person may present holding their elbow. Symptoms may include pain, swelling, and bruising. Generally good (proximal and shaft), Less good (distal) Ī humerus fracture is a break of the humerus bone in the upper arm. Proximal humerus, humerus shaft, distal humerus Injury to an artery or nerve, compartment syndrome Midshaft humerus fracture with callus formation
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