Upper arm fracture

An upper arm fracture, known in medical terms as a humerus fracture, generally occurs as a result of massive force when a person falls on their upper arm. The bone often breaks near the shoulder joint and this is known as a humeral head fracture or proximal humeral fracture. If the shoulder joint is involved, this is a shoulder fracture. Fractures near the elbow joint are called distal humeral fractures. Uncomplicated fractures without bone fragments that do not involve the joint can be treated conservatively. Conversely, in the case of fragment fractures or shoulder fractures, surgical treatment is recommended.

The upper arm bone (humerus) forms the connection between the elbow joint and the shoulder joint. An upper arm fracture is usually caused by falling or suffering a blow on the upper arm. However, older people with osteoporosis can already suffer an upper arm fracture without much force when falling and supporting themselves on their arm.

If you fracture your upper arm, this causes immediate severe pain. The movement of the upper arm of shoulder is severely limited. There is often swelling or a haematoma in the area of the fracture. If nerves are injured, this can cause loss of feeling or signs of paralysis.

The diagnosis of an upper arm fracture can normally already be made on the basis of the accident, the visible signs of a fracture and the symptoms. An x-ray provides information on the exact location and extent of the fracture. If there are suspected injuries to the tendons, ligaments or the joint, computed tomography will be carried out.

The treatment of an upper arm fracture depends on the severity of the fracture and where it is located. Uncomplicated fractures without any bone fragments or injuries to the soft tissue can be treated conservatively, unless the site of the fracture is close to the shoulder joint. If there is malposition of the broken bone, the break must firstly be set under local anaesthesia. Then, there is conservative treatment consisting of a support bandage which fixes the upper arm to the body in a right angle position. This support bandage, also known as a Gilchrist bandage, is worn for two to three weeks. Afterwards, the upper arm is further supported with a shoulder sling. The upper arm will be remobilised on a step-by-step basis while the patient is wearing the shoulder sling. Firstly with passive exercises and later with active exercises. Around six weeks after the fracture, the shoulder sling can be left off and the upper arm can increasingly be used as normal.

Surgical treatment is recommended in the case of comminuted fractures near the shoulder joint and open fractures. Find out more about the surgical treatment options in the Surgery on upper arm fractures section.