Humeral head fracture – fracture of the upper arm close to the shoulder
A humeral head fracture is a bone breakage around the head of the humerus, the end of the humerus (upper arm bone) proximal (closest) to the shoulder. The head of the humerus forms part of the shoulder joint with the joint socket of the shoulder blade, and is held in place by muscles, tendons and ligaments. This type of bone fracture requires careful treatment to avoid long-term consequences.
How does a humeral head fracture happen? Causes and risk factors
Humeral head fractures are often caused by sudden falls, sports injuries or accidents. The elderly and people with osteoporosis have a higher risk of fracturing the head of the humerus because their bones are more prone to breaking.
How do you prevent fracturing the head of the humerus?
Understanding the causes of a humeral head fracture is crucial for implementing preventive measures, such as:
Preventing falls
Elderly people should take particular care to prevent falls. This includes e.g. removing any stumbling hazards around their house, and wearing suitable, non-slip shoes. Tidy and well-lit surroundings, especially in areas where elderly people spend time, also helps prevent falls.
Healthy lifestyle habits
Healthy lifestyle habits: Having a generally healthy lifestyle, with a balanced diet and sufficient exercise, and reducing risky behaviours helps people maintain good general health, which also helps their bones stay healthy.
Improving bone strength
Getting enough calcium and vitamin D is crucial for strong bones. A healthy diet of calcium-rich foods such as dairy, green leafy vegetables and fish supports bone growth, while vitamin D can be absorbed through sun exposure or vitamin supplements. People with osteoporosis take the medication prescribed to them by their doctor.
Exercise
Exercise: Strength- and balance-training exercises can strengthen our muscles and improve our balance, which can reduce the risk of us falling. An active lifestyle also helps maintain good general bone health.
Symptoms and signs of a humeral head fracture
Common symptoms of a humeral head fracture are pain in the upper arm or shoulder area, which can radiate into the hand. Other symptoms: bruising and impaired arm mobility. In addition, motor and nerve function may be occasionally temporarily impaired. If you suspect a humeral head fracture is suspected, you must seek medical attention immediately.
Diagnosing a humeral head fracture: How is a fracture at the top of the arm diagnosed?
A humeral head fracture is usually diagnosed by a thorough medical examination and scans. Steps typically taken in diagnosing a humeral head fracture include:
Medical history and physical examination
During the doctor's appointment, patients are asked about the accident and the doctor conducts a physical examination. The doctor checks symptoms such as pain, limited mobility and any visible external injuries.
Diagnostic scans
-
X-rays: X-rays are often the first choice in diagnosing a humeral head fracture. They allow an accurate representation of the fracture and help the doctor determine the severity and type of fracture.
-
Magnetic resonance imaging (MRI) or computed tomography (CT) scan: In some cases, especially complex fractures or suspected secondary injuries, an MRI or CT scan can provide additional clues.
By using differential diagnosis, doctors rule out other possible causes of the symptoms and ensure that the symptoms are actually due to a humeral head fracture. The can do this by comparing the shoulder with the contralateral (opposite) unaffected side.
The exact diagnostic procedure can vary from patient to patient. However, a rapid, accurate diagnosis is crucial, to initiate appropriate treatment and minimise any potential complications.
Humeral head fracture therapy and treatment: surgical or conservative?
Further medical treatment depends on several factors such as the age of the patients, their level of activity, and the severity of their injury. Whether they receive conservative or surgical treatment depends on several factors, including the type of fracture and the person's own individual circumstances. Open communication between the patient and the doctor is key, in order to decide the optimum therapy.
Humeral head fracture – conservative treatment options
Humeral head fractures can be treated conservatively if the fracture is stable and the bone fragments are well-aligned. The patient's general state of health also plays an important role in assessing the risks, and deciding against or in favour of surgery.
It is important that the patient, the orthopaedist and the physiotherapist stay in close contact in order to monitor the progression of the conservative treatment and adjust it, if necessary. Common conservative treatment options include:
Pain management
Controlling pain is an important part of conservative therapy. Painkillers can be prescribed to help patients during the healing process.
Shoulder braces and immobilisation
The arm needs to be left immobilised for a certain period of time to allow the bone to heal without any interruption. This can be enabled by e.g. wearing a shoulder support (orthosis) or an arm sling.
Physiotheraphy
Physiotherapy should be started as early as possible, not only to prevent blood clots from forming, but also to maintain the mobility of the shoulder, wrist and elbow, and to minimise muscle loss. Physiotherapists can recommend special exercises to strengthen the muscles and improve the mobility of the arm.
Electrical stimulation and ultrasound therapy
These forms of therapy can help improve circulation, reduce swelling, and speed up the healing process.
Surgical reconstruction options after a humeral head fracture
The final decision for or against surgery is made on a case-by-case basis, based on a thorough examination and diagnostic scans, and taking into account the specific circumstances of those affected. The complexity of the fracture, the dislocation of the fragments and any accompanying soft-tissue injuries all play a role in the decision. In addition, surgery may be required if the joint surface is damaged enough that it needs to be reconstructed.
Surgical treatment options for humeral head fractures depend on several factors, including the type and severity of the fracture, the patients' age, level of activity, and other personal health aspects. Here are two of the surgical treatment options commonly used:
- Osteosynthesis: Surgeons can use metal plates and screws to fix the bone fragments in place. These plates are usually attached to the bone to stabilise the fracture until it has healed.
- Joint replacements: In the case of severe fractures or irreparable damage to the humeral head, endoprosthetic treatment (joint replacement surgery) may be considered. The broken humerus head is replaced with an artificial ball head.
After the operation, physiotherapy is usually required to promote rehabilitation and restore arm function.
Rehabilitation exercises for humeral head fractures
After a humeral head fracture, there are special exercises to promote mobilisation, strengthen your muscles and improve joint movement. Get medical advice on when the right time is, and whether the exercises are suitable for you.
What kind of doctors treat humeral head fractures?
Orthopaedists or trauma surgeons are the right points of contact for a humeral head fracture. They specialise in diagnosing and treating shoulder injuries.
medi products for humeral head fractures
The doctor decides the follow-up care to suit the individual patient: In the case of conservative therapy, patients can wear our Humeral fracture brace plus. After any surgery, the affected arm can be immobilised with a shoulder orthosis (brace).
