Humerus Fracture
A break in the upper arm bone, between the shoulder and elbow
Quick Facts
- Type: Bone fracture
- Bone affected: Humerus (upper arm bone)
- Common cause: Falls, direct blows, crashes
- Watch for: Nerve injury causing wrist or hand weakness
Overview
A humerus fracture is a break in the humerus, the long bone of the upper arm that runs from the shoulder down to the elbow. Fractures are described by where they occur: near the shoulder (proximal), in the middle of the bone (the shaft), or near the elbow (distal).
Humerus fractures are common and range from simple cracks that heal with a sling to more complex breaks that need surgery. The specific treatment depends on the location, how badly the bone is displaced, and the person's age and activity. A nerve that runs along the humerus can occasionally be injured, which is an important thing for doctors to check.
Symptoms
A humerus fracture usually causes immediate and obvious symptoms:
- Sudden, severe pain in the upper arm
- Swelling and bruising
- Tenderness over the break
- An inability to move the arm normally
- A visible deformity or shortening of the arm in severe breaks
- A grinding or grating sensation with movement
If the nerve that wraps around the bone is affected, there may be weakness in lifting the wrist or numbness on the back of the hand. New numbness, tingling, or weakness should be reported promptly.
Causes
Humerus fractures most often result from a sudden force to the arm or shoulder:
- Falling onto an outstretched arm or directly onto the shoulder
- A direct blow to the upper arm
- Motor vehicle or sports collisions
- Twisting injuries
In older adults, especially those with osteoporosis, fractures near the shoulder can occur with a relatively minor fall. Rarely, a fracture can occur where bone has been weakened by disease. The location of the break often reflects the type of injury: a fall onto an outstretched hand tends to affect the area near the shoulder, while a direct blow more often breaks the middle of the bone. Knowing how the injury happened helps doctors anticipate the fracture pattern and check for related problems such as nerve injury.
Risk Factors
- Osteoporosis or other conditions that weaken bone
- Older age, with a higher risk of falls
- Participation in contact or high-speed sports
- Activities with a risk of falling from height
- Previous fractures
Diagnosis
Diagnosis is based on examination and imaging, with a careful check of nerves and blood flow.
- Physical exam: assessing the arm, and testing sensation, movement, and pulse to check for nerve or blood vessel involvement
- X-rays: the main test to confirm the fracture and show its location and pattern
- CT scan: sometimes used for complex fractures, particularly near the shoulder or elbow, to guide treatment
Treatment
Treatment depends on the location and severity of the fracture.
- Non-surgical care: many fractures, especially of the shaft and many near the shoulder, heal with a sling, brace, or splint, along with pain relief and gradual movement
- Surgery: used for fractures that are badly out of place, involve the joint, are open wounds, or come with nerve or blood vessel injury; the bone may be fixed with plates, screws, rods, or pins
- Physical therapy: exercises to restore strength and motion in the shoulder, elbow, and hand as the bone heals
Most humerus fractures heal well, though recovery can take several weeks to a few months depending on the injury.
Prevention
- Take steps to prevent falls, especially for older adults, such as removing trip hazards and improving lighting
- Keep bones strong with adequate calcium, vitamin D, and weight-bearing activity
- Manage osteoporosis if present
- Use protective gear during contact sports and wear seat belts
- Stay active to maintain strength and balance, which helps prevent falls
When to See a Doctor
Seek emergency care for a suspected broken upper arm, especially if you have:
- Severe pain and inability to move the arm after an injury
- An obvious deformity, severe swelling, or an open wound with bone exposed
- Numbness, tingling, or weakness in the hand or wrist, which may signal nerve injury
- A cold, pale, or pulseless hand, which is an emergency
Until help is available, keep the arm still and supported. Prompt care allows the fracture and any nerve injury to be treated properly.
Frequently Asked Questions
What are the signs of a broken upper arm?
Common signs include sudden severe upper arm pain, swelling, bruising, tenderness, inability to move the arm normally, and sometimes a visible deformity or a grinding sensation. Numbness or weakness in the hand may indicate a nerve injury.
Does a humerus fracture always need surgery?
No. Many humerus fractures, especially of the shaft and many near the shoulder, heal with a sling or brace, pain relief, and gradual physical therapy. Surgery is used for fractures that are badly displaced, involve a joint, are open, or have nerve or blood vessel injury.
Why do doctors check the nerves with a humerus fracture?
A nerve runs along the humerus and can be injured by the break. Doctors test the ability to lift the wrist and sensation on the back of the hand. New numbness, tingling, or weakness should be reported, as it can indicate nerve involvement.
How long does a humerus fracture take to heal?
Most heal over several weeks to a few months, depending on the location and severity of the break and whether surgery was needed. Physical therapy helps restore strength and motion, and your doctor will guide your recovery timeline.
When is a humerus fracture an emergency?
Seek emergency care for severe pain with inability to move the arm, an obvious deformity, an open wound with exposed bone, numbness or weakness in the hand, or a cold, pale, or pulseless hand, which needs immediate treatment.
References
- American Academy of Orthopaedic Surgeons (AAOS). Humerus Fractures.
- MedlinePlus, U.S. National Library of Medicine. Fractures.
- Mayo Clinic. Broken arm.
- OrthoInfo, AAOS.