Mid Humeral Fracture

The upper arm is made up of the humerus bone. The head of the humerus fits into a shallow socket in your scapula (shoulder blade) to form the shoulder joint. The humerus narrows down into a cylindrical shaft and joins at its base with the bones of the lower arm to form the elbow joint.

Fractures can occur at any site of the humeral bone. Mid humeral fractures are fractures that occur in between the shoulder joint and elbow. They are classified into Type A, B or C fractures. Type A fractures are simple fractures where the bone is not shattered. Type B fractures are fractures when the broken bone forms a wedge, and type C fractures are where the bone is shattered into many pieces.

Causes

Mid humeral fractures can be caused by:

A direct blow or bending force applied to the middle of the humerus
falling onto an outstretched arm
violent muscle contraction in sports such as weight lifting

Signs and Symptoms

Patients usually present with considerable pain and swelling following a mid-humeral fracture. Shortening of the arm is apparent with significant displacement of the bones.

Diagnosis

Mid humeral fractures can be diagnosed through X-ray imaging and ultrasound.

Treatment

Most mid humeral fractures can be successfully treated through conservative treatment without the need for surgery. Your doctor may place the limb in a hanging arm cast or a co-aptation splint for 1-3 weeks followed by a functional brace. Patients will be instructed on range of motion exercises of the fingers, wrist, elbow and shoulder as soon as can be tolerated.

Surgical treatment

Surgical treatment is recommended for

Fractures that cannot be managed conservatively
Segmental fractures
Pathologic fractures (bone tumor)
When blood vessels get injured
Patients who need to have upper extremity weight-bearing capability
Open fractures when the skin is opened by the fractured bone
Obese patients in whom alignment is difficult

Surgical treatment is called open reduction and internal fixation (ORIF). This procedure is usually performed under general anesthesia. First your broken bones are put back into their normal anatomic position. Internal fixation devices such as plates, screws, or intramedullary (IM) implants are then used to hold your broken bones together. You will be placed in a dressing and/or cast following your procedure.