A humeral shaft fracture is a fracture of the the humerus (arm bone). It can occur in young individuals usually due to high-energy injuries resulting from vehicular accidents or sports. In older individuals these fractures may result from simple falls. Osteoporosis may be a contributory fracture in older individuals.

How is a humeral shaft fracture diagnosed?

Fractures of the humerus may be suspected from the mechanism of injury resulting in pain and deformity in the arm. The arm usually develops swelling and bruising. The diagnosis is confirmed on X-rays of the arm.  

How is a humeral shaft fracture treated?

Non-operative treatment

The initial treatment will consist of protecting the arm in a brace and supporting it in a sling, the use of oral pain medication and advice on protection of the arm. Whilst your arm is in a sling you will be advised to keep the fingers, wrist and elbow moving to prevent stiffness. As the pain in the arm settles, you will be encouraged to start gradually moving the shoulder. If the fracture is minimally displaced, then this treatment is continued until the fracture has healed.

Surgical treatment

In instances where it is difficult to hold the alignment of the fracture in a satisfactory position with a brace, the fracture may be treated surgically. The exact nature of the operation will depend on the type of fracture. Surgery may also be offered if the fracture fails to heal after 3-6 months in a brace (a fracture that fails to heal is referred to as a "nonunion").

Operative fixation: This is the preferred method of treatment in selected individuals with displaced fractures or fractures which have failed to heal after a period of nonsurgical treatment. It consists of realigning the fragments and then fixing the fragments with a plate or an intramedullary nail (or "rod"), which hold the position of the fragments until the fracture has healed. The fracture will usually go on to heal over a period of 3 to 6 months.

How long does it take to recover from a humeral shaft fracture?

Recovery will depend to some extent on the severity of the fracture and the type of treatment. Pain usually starts easing within a couple of weeks. You may start using the hand as the arm gets comfortable. You will initially be moving the arm with assistance and independent use is often allowed after 6-12 weeks. A gradual functional recovery continues for 12-15 months after the injury.