Humeral Shaft Fractures

By: Robert Daniel Lim, PTA

What  Causes Humeral Shaft Fractures?

The most common cause of a humeral shaft fracture is a fall with an outstretched arm or a traumatic injury. Possible causes include a car accident or a blunt type of trauma such a hit during a football game or a hit from an object such as a bat or stick. Most individuals that have weak bone such as people with osteoporosis have a higher risk of humeral shaft fractures.

X-ray image of a humeral shaft fracture with label and arrows pointing to the fracture

What is a Humeral Shaft Fracture?

A humeral shaft fracture is a break or compromise in the bone, localized at the mid portion of the upper arm. 

There are 3 different types of humeral shaft fractures. This depending on the location of the break:

  1. Proximal Humerus Fracture - A proximal humerus fracture is a break in the upper part of your humerus near or under the head of the humerus
  2. Humeral Shaft Fracture - A shaft humerus fracture is a break in the middle of your humerus bone.
  3. Distal Humerus Fracture - A distal humeral shaft fracture is a break in the lower portion of your humerus.  Usually area around the elbow

Anatomy of the Humerus

The humerus is the long bone that runs from the top part of the shoulder that runs down to the elbow.  The shoulder joint is considered a ball and socket joint. The ball is the humeral head, and the socket is the glenoid fossa of the scapula.  The humerus provides structural support for the upper arm and is an attachment point for numerous muscles that help move the upper arm and the elbow.  

Below are the parts that comprise the humerus bone:

  • Head of humerus: This is the rounded part of the proximal humerus.  This is also known at the ‘ball”.
  • Tubercles: There are two tubercles in the humerus bone.  They are called greater and lesser tubercle.  These serve as attachment points for the muscles in the shoulder joint.
  • Surgical neck:  This is the area at the base of the proximal humerus.  This its below the ball area.  This is the most common area for fractures of the humerus.
  • Epicondyles:  These are the bony protrusions at the distal end of the humerus. There are two epicondyles. These are called the medial and lateral epicondyles. These are protrusions that hold muscles of the lower aspect of the arm, wrist and hand.

image of a humerus with labels showing the specific anatomical landmarks on the bone.

What are the Common Symptoms of a Humeral Shaft Fracture?

You might be wondering if you have a humeral shaft fracture. Now you are wondering what the common symptoms of a humeral shaft fracture are. The most common sign will be pain either at the site of the fracture or pain in the arm and elbow area. Usually with pain the next common sign will either be bruising or swelling the in area. Next, the inability to move the arm due to pain as well as severe weakness might be present. A simple deformity such as “It does not look normal or there looks like a divot in my arm might be present as well. If you have any of these types of symptoms especially if you have lost of function as well as a change in temperature or movement, please contact your primary care physician, orthopedic doctor or go to the Emergency Department in the worst case scenario.

How are Humeral Shaft Fractures Diagnosed?

The most common way a humeral shaft fracture is diagnosed is via X-Ray. X-ray’s will show any fractures/breaks in the arm/shoulder. If there are any signs of lost of function, your doctor might order an MRI or CT scan to rule out any tears that may have been caused by the fall or injury. Depending on the severity and if your doctor may feel that physical therapy or occupational therapy could benefit you

Potential Issues From a Humeral Fracture

Radial nerve injury can be a complication of a humeral fracture especially when the fracture is in the middle or distal aspect. The radial nerve is a nerve that runs through your arm.

When the radial nerve is injured or compromised, you might have something called wrist drop.  Wrist drop is caused because the radial nerve controls the extensor muscles of the wrist and fingers. Common symptoms of wrist drop are weakness of the wrist and fingers, difficulty with straighten the wrist or fingers, numbness or tingling of the hand and fingers, pain in the wrist or hand, muscle tone decreasing in the wrist or hand. 

How are Humeral Shaft Fractures Treated with Physical Therapy?

Humeral shaft fractures can be treated via surgery or non-surgically. This depends on severity of the fracture. If your doctor feels that the non-surgical option is the way to go, your doctor might place you into a cast/splint or shoulder sling until the fracture heals. This might take a few weeks to a few months for this to heal and take form. Now that the fracture is healed, your doctor might prescribe physical therapy

Physical therapy will involve increasing activities to restore strength, joint motion and flexibility. The patient must complete range of motion and strengthening exercises on a daily basis to see overall progress. Physical therapy will continue until the muscles, ligaments and other soft tissues perform normally in a way that your are able to perform function on a daily basis.

Related Links:

If you have and injury or fracture, the Jacksonville Orthopaedic Institute can help. To schedule and appointment with a JOI Orthopedic Doctor, call (904)JOI-2000, schedule online, or click the link below. To see a JOI Rehab Therapist, call (904)858-7045.

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