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 extended arm or elbow (especially in children aged 5-7 years old) can cause a fracture of the upper arm just above the elbow (fractura supracondylaris humeri), which in 10% can lead to pinching of blood vessels and nervesAndersen MJ. 2023).
Symptoms
Sudden onset of pain around the elbow and pain-induced restriction of movement of the arm after a heavy load (fall) or direct trauma.
Examination
The elbow is usually very tender with swelling, haematoma, dislocation and reduced mobility. Sudden onset of severe arm pain with restricted movement after a fall should lead to urgent medical attention due to the risk of damage to blood vessels and nerves.
A detailed examination of vascular and nerve conditions should always be performed. X-ray in 3 projections can usually show the fracture and determine treatment based on the type of fracture.
Treatment
Simple fractures can be treated with a plaster cast, while complicated fractures that may involve vessels and nerves require emergency open surgery.
Rehabilitation
Once the pain has subsided and the bandage has been removed, you can start cardio training in the form of cycling and running, as well as rehabilitation according to the guidelines under rehabilitation in general.
For surgical treatment, there may be specific considerations that the operator informs about.
Complications
In the vast majority of cases, the fracture heals without complications. In about 10%, the blood vessel and nerve supply to the arm may be affected. In rare cases (0.5%), acute and chronic compartment syndrome may occur.
