Fracture of Humerus

The humerus is the long bone of your upper arm. It extends from your
shoulder to your elbow, where it joins with the ulna and radius bones of
your forearm.
The pain from a humerus fracture often extends to shoulder or elbow,
depending on where the break is, and recovery may last several weeks.
 Types
• There are three types of humerus fracture, depending on the location
of the break:
1. Proximal. A proximal humerus fracture is a break in the upper part
of your humerus near your shoulder.
2. Mid-shaft. A mid-shaft humerus fracture is a break in the middle of
your humerus.
3. Distal. Distal humerus fractures occur near your elbow. This type is
usually part of a more complex elbow injury and sometimes involves
loose bone fragments.
Causes
• Overstretched arm can cause mid-shaft and proximal humerus
fractures.
• A high-impact collision such as a car accident or football tackle, is
more likely to cause a distal humerus fracture.
• Things that can cause pathologic humerus fractures include:
• osteoporosis
• bone cancer
• bone cysts or tumors
 Sign and Symptom
• pain is immediate, enduring, and exacerbated with the slightest
movements.
• swelling with bruising appearing a day or two after the fracture.
• discoloration of the skin at the site of the fracture.
• A crackling or rattling sound may also be present caused by the
fractured humerus pressing against itself.
• loss of control or sensation in the arm below the fracture if nerve
affected.
• diminished pulse at the wrist if fracture affect blood supply.
• Displaced fractures of the humerus shaft will often cause deformity
and a shortening length of the upper arm.
 Nonsurgical Treatment

• Immobilization by wearing a sling and with time the fracture will heal.
Casting is not possible with most types of humerus fractures
• Pain control. Physicians will often prescribe NSAIDs such as ibuprofen
during the healing process.
• Range-of-motion exercises. Gentle range-of-motion exercises may begin
7 to 10 days after injury.
• Physical therapy. Physical therapy can start 2 to 3 weeks after the injury
occurs.
 Surgical Treatment

• Open reduction and internal fixation.

Internal fixation - method of physically reconnecting the bones. This
method uses special screws, plates, wires, or nails to align the bones
correctly. This prevents the bones from healing abnormally.
open reduction - reposition the pieces of your fractured bone surgically
so that your bones are back in their proper alignment.
 Nursing Management
1. Monitor 5P (pain, pulse, pallor, paresthesia, paralysis) on the
affected extremity.
2. Rest patient in bed.
3. If patient cannot elevate the fracture part, administer cold
compress followed by hot compress to reduce edema.
4. Administer pain medication such as acetaminophen to relieve the
pain.
5. Check patient temperature regularly to detect early sign of
infection.
6. Encourage patient to exercise the elbow, wrist and fingers to
prevent the part getting stiffness. Vigorous activity is limited for 3
months.
7. Educate patient proper way to use the arm sling.
8. Emphasise patient about the follow up. Patient need to see doctor
regularly until the fracture heals. During these visits, doctor will
take x-rays to make sure the bone is healing in a good position.
 Complication

1. Nonunion
2. Malunion
3. Nerve injury
4. Shoulder or elbow stiffness or weakness