Anatomy
The humerus consists of the head (caput), the neck (collum), the long bone (corpus) and the joint-forming part in the elbow (epicondyle).
Upper arm from the front:
A. Caput humeri
B. Collum chirurgicum
C. Epicondylus medialis
D. Epicondylus lateralis
E. Tuberculum minus
F. Sulcus intertubercularis
G. Tuberculum majus
H. Collum anatomicum
Cause
A direct fall on an outstretched arm, forceful rotation of the arm or direct trauma can cause a fracture of the humerus. The fracture can occur anywhere on the humerus, but fractures in the centre of the long bone (corpus) are common.
Symptoms
Sudden onset of pain and pain-induced restriction of movement of the arm after a heavy load (fall, blow). Possibly angulation of the upper arm can be seen.
Examination
Sudden severe pain in the arm with restricted movement after a fall should always lead to an urgent medical examination (possibly in a hospital). Often there is a haematoma. X-rays can usually show the fracture and determine treatment based on the type of fracture.
Treatment
Fractures in the centre of the arm without significant malalignment are usually treated with a rigid bandage (Sariento bandage).Healing time is usually 2-3 months. 10-15% require surgery later due to lack of healing. If there is significant dislocation or the fracture is close to the elbow, surgery may be primarily necessary (Oliver WM, et al. 2023).
Rehabilitation
Once the pain has subsided and the bandage has been removed, you can start cardio training in the form of cycling and rehabilitation according to the guidelines under rehabilitation in general. After about 4-6 weeks, you can start running and immediately afterwards gentle muscle training of the upper arm and shoulder muscles.
Only after about 3 months will you be able to participate in contact sports. For surgical treatment, there may be specific considerations that the surgeon will inform you about.
Complications
In the vast majority of cases, the fracture heals without complications, but around 10% experience failure to heal and require further surgery. In some cases, the fracture can affect the nerve supply to the arm (N radialis), which can cause sensory disturbances in the hand (and is often treated with (re-) surgery).
