Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Fractures of the Humerus

Fractures of the upper part of the humerus occur most frequently as a result of falling on an outstretched arm, but they may also follow a direct fall on the shoulder during contact sports, such as rugby and American football, alpine skiing, and riding. Fractures of the upper part of the humerus occur most frequently through the surgical neck of the humerus. Sometimes they are avulsion fractures of the greater tubercle (supraspinatus tendon insertion) or the lesser tubercle (subscapularis tendon insertion).

Symptoms and diagnosis

Tenderness and swelling occur over the area of the injury, and pain is experienced on attempted movement.

Treatment

– The injured person should be taken to a doctor or a hospital for examination and an X-ray.
– A support bandage is applied and kept in position for a few days, after which mobility training is begun. Mobility training starts with pendulum movements and progresses to the exercises.
– Physiotherapy aids the process of rehabilitation. If the displacement of the avulsed tubercle is great or interferes with the range of motion, surgery should be considered.

Healing

As a rule, fractures of the upper part of the humerus heal well, and conditioning can be resumed after 4–8 weeks.

Fractures of the midshaft of the humerus can occur in riders, wrestlers, and other athletes. They are usually treated by cast bracing or occasionally by strapping the arm to the body for 3–6 weeks. Surgery may occasionally be necessary. A rehabilitation period of 3–6 months is advisable before resumption of any sporting activity involving the use of the injured arm.
Stress fractures of the humerus can occasionally occur, e.g. in javelin throwers.

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