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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