Humerus Fracture

What are humerus fractures?

A humerus fracture is the medical name for breaking the bone in your upper arm (your humerus). Humerus fractures are usually caused by traumas like car accidents or falls.

If you break your humerus, you might need surgery to repair your bone. Some people can recover without surgery and only need a splint, cast or sling. You’ll need physical therapy to regain your ability to move your arm.

Types of fractures

Your healthcare provider will assign your fracture a type or classification depending on how your humerus is broken. Some fractures are classified by the shape or pattern of the break line:

• Transverse fracture.
• Oblique fracture.
• Spiral fracture.
• Segmental fracture.
• Comminuted fracture.
• Impacted fracture.
• Buckle fracture.
• Hairline fracture.

Some types of fractures are classified by how they happen:

• Stress fracture.
• Avulsion fracture.

Supracondylar humerus fractures

If you break your humerus right above your elbow, you might have what’s called a supracondylar fracture. This is a type of elbow fracture that almost always affects kids. Supracondylar humerus fractures are usually caused by a child catching themselves from a fall with their arm stretched out in front of them. Your provider will diagnose and treat a supracondylar fracture like any other broken bone.

Open vs. closed fractures

Your healthcare provider will classify your fracture as either open or closed. If you have an open fracture your bone breaks through your skin. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.

Displaced humerus fractures

Displaced or non-displaced are more words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough during the break to be out of alignment. Displaced fractures are much more likely to require surgery to repair.

Humerus fracture locations and anatomy

Your provider might reference where on your humerus you experienced a fracture. There are lots of terms providers use to talk about specific bones, but the most common ones you’ll hear are:

• Location (proximal and distal): Proximal and distal are words that describe where a fracture is located along your bone’s length. The proximal end of your humerus is the top. The distal end is the bottom. So, if you have a proximal humerus fracture, your upper arm bone is broken near its top — the end that connects to your shoulder. Similarly, if you have a distal humerus fracture that means your bone is broken at the bottom, closer to your elbow.
• Anatomy (parts of your bones): Even though your bones are one piece, they have many parts that can be damaged during a fracture. Your humerus has a head (your proximal aspect, near your shoulder), shaft and distal aspect (the end at the bottom, near your elbow). Other common labels like the surgical neck and greater tuberosity are just specific areas on your bone. These terms are usually more for your healthcare provider to use as they describe where your bone is damaged.

Who gets humerus fractures?

Humerus fractures — like all bone fractures — can affect anyone. This is especially true because they’re caused by serious traumas. There’s no way to predict when or how someone will be in an accident, so everyone could experience one.

How common are humerus fractures?

Humerus fractures are rare. They’re less than 10% of all broken bones.

It’s more common to break your humerus at its top where it meets your shoulder (a proximal humerus fracture) than at the bottom where it meets your elbow (a distal humerus fracture).

What are the symptoms of a humerus fracture?

Symptoms of humerus fractures include:

• Pain.
• Swelling.
• Tenderness.
• Inability to move your arm like you usually can.
• Bruising or discoloration.
• A deformity or bump that’s not usually on your body.

If you fracture your humerus, there’s a chance the other tissue around your bone is damaged too. This includes:

• Muscles: Your biceps and triceps.
• Nerves: Your median nerve, ulnar nerve and radial nerve are all connected to your humerus.
• Blood supply: Your brachial artery and vein.

What causes humerus fractures?

Humerus fractures are almost always caused by traumas. Your humerus is one of the strongest bones in your body, and something has to hit your upper arm with a lot of force to break it. Some of the most common causes include:

• Car accidents.
• Falls.
• Sports injuries.

You’re more likely to experience a fracture if your bones are weakened by osteoporosis.

Osteoporosis

Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. Many people don’t know they have osteoporosis until after it causes them to break a bone. There usually aren’t obvious symptoms.

Women, people assigned female at birth and adults older than 50 have an increased risk for developing osteoporosis. Talk to your provider about a bone density screening that can catch osteoporosis before it causes a fracture.

How are humerus fractures diagnosed?

Your healthcare provider will diagnose a humerus fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room if you’re admitted after a trauma.

If you’re taken to the ER, a team of providers stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you’re stabilized, you will need imaging tests to confirm your fracture.

What tests are done to diagnose humerus fractures?

You’ll need at least one of a few imaging tests to take pictures of your fracture:

• X-rays: An X-ray will confirm any fractures, and show how damaged your bones are.
• Magnetic Resonance Imaging (MRI): Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. This will show them the tissue around your bones too.
• CT scan: A CT scan will give your provider or surgeon a more detailed picture of your bones and the surrounding tissue than an X-ray.

How are humerus fractures treated?

How your fracture is treated depends on which type it is, what caused it and how damaged your bones are.

Immobilization

If your fracture is mild and your bones did not move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases, you’ll likely need follow-up X-rays to make sure your bones are healing correctly.

You might need a sling to hold your shoulder and arm in place, especially if your humerus is fractured at the proximal end near your shoulder.

Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this nonsurgical procedure, your provider will physically push and pull your body on the outside to line up the broken bones inside you. To prevent you from feeling pain during the procedure you’ll receive one of the following:

• Local anesthetic to numb the area around your fracture.
• Sedatives to relax your whole body.
• General anesthesia to make you sleep through the procedure.

After the closed reduction, your provider will put you in a splint or cast.

Humerus fracture surgery

Some humerus fractures require surgery. Depending on which type of fracture you have, and how badly your bones are damaged there are a few techniques your surgeon might use.

Internal fixation

Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll need to limit how much you use your arm to make sure your bone can fully heal.

Internal fixation techniques include:

• Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
• Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
• Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’re typically used at the same time as rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

Arthroplasty

If you fracture your elbow or shoulder joint, you might need an arthroplasty (joint replacement). Your surgeon will remove the damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. The new joint will look like your natural joint and move in a similar way.

Bone grafting

You might need bone grafting if your humerus fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

After your surgery, your arm will be immobilized. You’ll need some combination of a splint, cast or sling before you can start using it as you did before your fracture.

What medications are used to treat humerus fractures?

Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.

NSAID side effects

Side effects of NSAIDs include:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

Complications of humerus fracture treatment

Fracture surgery complications include:

• Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don't line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.
• Other internal damage: Fractures can damage the area around the injury including your muscles, nerves, blood vessels, tendons and ligaments.

How soon after treatment will I feel better?

It might take a few weeks for your symptoms to improve. Depending on which type of immobilization or surgery you needed to repair your fracture, you should be able to start moving again in a few weeks.

Contact your healthcare provider right away if you experience intense pain that doesn’t get better.

How can I reduce my risk for humerus fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that will help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.
• Use a cane or walker if you have difficulty walking or have an increased risk for falls.

What can I expect if I experience a humerus fracture?

You should expect to make a full recovery if you break your humerus. You’ll need physical therapy to regain strength and range of motion in your arm.

How long does it take humerus fractures to heal?

How long it takes you to heal depends on the severity of your fracture and which treatments you needed. Most people need a few months to recover from a humerus fracture.

There are lots of factors that can affect how long it takes your body to heal. Talk to your provider or surgeon about a timeline that fits your specific situation.

Will I need to miss work or school?

Your specific injuries and which bones are fractured will impact how long you’ll need to miss work, school and other activities. Talk to your surgeon or healthcare provider before resuming any physical activities or playing sports while you’re recovering.

When should I go to the emergency room?

If you think you have a humerus fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You can’t move your arm like you usually can.
• Your arm is noticeably different looking or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced a trauma.

What questions should I ask my doctor?

• What type of fracture do I have?
• Will I need surgery?
• How long will it take to recover?
• When can I resume physical activities or play sports?

A note from Cleveland Clinic

Your humerus is the only bone in your upper arm, and it’s one of the strongest bones in your body. Usually, people who experience humerus fractures are involved in a serious trauma like a car accident. Even if you need surgery to repair your bone, you should expect to make a full recovery after a humerus fracture.