How are humerus fractures treated?
How your fracture is treated depends on which type it is, what caused it and how damaged your bones are.
Immobilization
If your fracture is mild and your bones did not move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases, you’ll likely need follow-up X-rays to make sure your bones are healing correctly.
You might need a sling to hold your shoulder and arm in place, especially if your humerus is fractured at the proximal end near your shoulder.
Closed reduction
More severe breaks require a closed reduction to set (realign) your bones. During this nonsurgical procedure, your provider will physically push and pull your body on the outside to line up the broken bones inside you. To prevent you from feeling pain during the procedure you’ll receive one of the following:
- Local anesthetic to numb the area around your fracture.
- Sedatives to relax your whole body.
- General anesthesia to make you sleep through the procedure.
After the closed reduction, your provider will put you in a splint or cast.
Humerus fracture surgery
Some humerus fractures require surgery. Depending on which type of fracture you have, and how badly your bones are damaged there are a few techniques your surgeon might use.
Internal fixation
Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll need to limit how much you use your arm to make sure your bone can fully heal.
Internal fixation techniques include:
- Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
- Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
- Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’re typically used at the same time as rods or plates.
Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.
Arthroplasty
If you fracture your elbow or shoulder joint, you might need an arthroplasty (joint replacement). Your surgeon will remove the damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. The new joint will look like your natural joint and move in a similar way.
Bone grafting
You might need bone grafting if your humerus fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:
- Internally from somewhere else in your body — usually the top of your hip bone.
- An external donor.
- An artificial replacement piece.
After your surgery, your arm will be immobilized. You’ll need some combination of a splint, cast or sling before you can start using it as you did before your fracture.
What medications are used to treat humerus fractures?
Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.
NSAID side effects
Side effects of NSAIDs include:
- Bleeding.
- Ulcers.
- Stomach pain.
- Bowel complications.
Complications of humerus fracture treatment
Fracture surgery complications include:
- Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
- Malunion: This happens when your broken bones don't line up correctly while they heal.
- Nonunion: Your bones may not grow back together fully or at all.
- Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.
- Other internal damage: Fractures can damage the area around the injury including your muscles, nerves, blood vessels, tendons and ligaments.
How soon after treatment will I feel better?
It might take a few weeks for your symptoms to improve. Depending on which type of immobilization or surgery you needed to repair your fracture, you should be able to start moving again in a few weeks.
Contact your healthcare provider right away if you experience intense pain that doesn’t get better.
