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 the shoulder or a fall on an extended arm can result in a fracture of the humerus. The fracture can occur anywhere on the humerus – at the shoulder joint, the centre of the humerus and at the elbow, but fractures through the neck of the humerus (collum) and the centre of the long bone are most common. Fractures involving the articular surfaces are the most complicated with the highest risk of long-term damage.
Symptoms
Sudden onset of pain and pain-induced restriction of movement of the arm after a fall or direct trauma.
Examination
Sudden onset of severe pain in the arm with limited movement after a fall should lead to examination by a relevant professional on suspicion of a fracture (possibly emergency hospitalisation). X-rays can usually show the fracture and determine treatment based on the type of fracture.
Treatment
Depending on the type of fracture, you may choose to relieve and possibly bandage the fracture until the pain subsides and the fracture is stable (which often takes about 6 weeks). Most fractures are treated without surgery. For special fracture types and misalignment, surgery may be indicated (Handoll HH, et al. 2022).
Rehabilitation, especially
Once the pain has subsided (after 2-3 weeks), you can start cardio training in the form of cycling and rehabilitation according to the guidelines under rehabilitation, 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 operator informs about.
Bandage
Special plastic bandages can be manufactured to be used when contact sports are resumed.
Complications
In the vast majority of cases, the fracture heals without complications. However, in some cases there is a delay in healing, possibly with the development of a false joint (pseudoarthrosis) that requires (re)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 usually treated with (re-) surgery). If the fracture involves the articular surfaces, the risk of later development of osteoarthritis is increased.
