Humeral Fracture: Causes, Symptoms, Treatment, Recovery, Exercise

The humerus is the longest bone present in the upper arm. When there is a crack or a break in this bone then it is called as Humeral Fracture or broken humerus. The humerus is a part of the shoulder joint and connects with the shoulder blade and also connects to the radius and the ulna, which are the bones of the forearm to form the elbow joint. An individual can sustain a Humeral Fracture due to a fall directly on the arm or elbow, a direct trauma to the hand in the form of a tackle while playing contact sports like football, rugby etc. A Humeral Fracture can be displaced or nondisplaced based on the nature of the injury sustained. Humeral Fracture usually occurs in three different regions of which one is around the shoulder, the humeral shaft, and the elbow.

As stated, Humeral Fracture can occur due to a fall on outstretched hands, falling directly on the elbow or shoulder usually following a tackle while playing contact sports like football, jockey etc. or due to a motorcycle crash in which the rider usually falls on the hands or shoulders.

Immediately following the injury or trauma, if the individual has sustained a Humeral Fracture then he or she will experience immediate inset of severe pain. The individual will not be able to move the shoulder either up or down. If the individual attempts to move the arm then there will be worsening of pain. Pain may also worsen when lying on the affected side. Another classic feature of a Humeral Fracture is an audible pop or a snap which the individual will hear at the time of injury. There will also be severe swelling at the injured site. A couple of days after the injury, there will be palpable tenderness and severe bruising around the area of injury. If the individual has suffered severe displaced fracture of the humerus then there may also be a visible deformity of the affected hand.

To begin with, the physician will examine the area of injury and attempt to move the hand to look for any pain. The physician will also look for any areas of tenderness around the injury site. If a fracture is suspected then radiologic studies in the form of an x-ray will be ordered to look at the extent of the fracture and whether the fracture is displaced or nondisplaced.

To begin with, the patient will be given NSAIDs like ibuprofen or Tylenol to calm down the pain and swelling and once the pain and swelling has calmed down then the physician decides on the treatment approach depending on the type and severity of the fracture.

In cases of a displaced Humeral Fracture, the patient will require a surgical procedure called as open reduction and internal fixation of the fracture. In this method, the fracture is first realigned under anesthesia and then stabilization of the fracture takes place by utilizing plates and screws. The patient is then put in a sling or a fiber cast for a few weeks so that stabilization is maintained. During this period, regular x-rays are taken of the affected arm to check for the status of healing.

In cases of nondisplaced fracture of the humerus, the patient will just be put in a cast or a sling for a few weeks with periodic x-rays taken to check on the healing process of the fracture. Once the patient has achieved adequate healing then the rehabilitation process is started and the physical therapist will design a therapy program best suited for you. The patient will be advised to take adequate rest and not to engage in activities that may put extra stress on the injury site like lifting, pushing or pulling with the injured hand. The patient will be started on gentle range of motion exercises to begin with and passive stretching. Once the patient is able to do these exercises without any pain or symptoms then further advanced exercises will be started. Once the patient has full pain-free range of motion and flexibility which may take a few months then the physician may allow gradual return to activity which can be gradually increased as symptoms dictates.

Recovery in almost all the cases of Humeral Fracture is full with adequate treatment and management along with aggressive rehabilitation. The patient is recommended to rest the injured arm till healing is complete and then return to activities gradually which may take a few months and is best decided by the physician and the therapist. In some cases such as those in which patient is involved in a motorcycle crash there may be injury to the adjacent structures of the hand also such as the ligaments and tendons which may take further time to heal. In cases of nondisplaced and minor fracture of humerus bone, recovery period or the healing time is between 6-8 weeks.

The below mentioned exercises are recommended for people with Humeral Fracture but are to be performed in the post recovery phase under the guidance of a physical therapist. Before beginning these exercises you should consult with the therapist about whether you can do these exercises or not. These exercises should be performed at least thrice a day provided that they do not aggravate your symptoms. These exercises aids in early recovery and returning to normal activities following Humeral Fracture.

Chest Expansion or Shoulder Blade Squeeze Exercise: You can perform this exercise either sitting or standing. Keep the back straight and try moving your shoulder backwards such that your chest gets expanded in front. Perform this squeezing movement of the shoulder blades as much as possible without aggravating the symptoms. Do this for a few seconds and then release.

Hanging Back and Forth Motion and Sideway Motion of the Arm: To do this exercise, rest the unaffected arm on a table such that your back is bent forward, with your weight falling on the unaffected arm and the table. Keep the affected arm hanging straight and now try and gently swing the injured arm back and forth as far as possible without aggravating the symptoms. Next, perform the same exercise but this time move the arm sideways. Do it about 10 times both ways.

Hanging Circular Motion of the Arm Exercise: To do this exercise, rest the unaffected arm on a table such that your back is bent forward, with your weight falling on the unaffected arm and the table. Keep the affected arm hanging straight and now try and gently rotate the affected arm in circles without increasing the symptoms, both clockwise and anticlockwise. Do it about 10 times in both directions.

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