Ortho-trauma » Trauma » Upper Limb

Humeral Fractures

In fractures of the greater tubercle of the humerus, if the dislocation is so minimal immobilize the joint in a sling for a maximum of 2 - 3 weeks. In major dislocations surgery is needed. In fractures of the neck of the humerus, conservative treatment and cautious early mobilization is indicated when the primary dislocation is minimal or when an acceptable position is achieved with reduction. More severely dislocated fractures should be reduced and immobilized with an arm-to-chest bandage for 3 - 6 weeks. Two part, three part, or four part displacement with >1 cm displacement need operative repair while dsplacement with 4 part fracture interrupting blood supply need prosthetic replacement of the proximal humerus. For fractures of diaphysis and distal part of the humerus, reduction performed preferably in a sitting position. Surgery (fixation with a plate and screws or with an intramedullary nail) is needed primarily in open fractures or if there is suspicion of radial nerve entrapment at the site of fracture. A non-dislocated condylar fracture is treated conservatively with an angular cast for 3 weeks. A dislocated condylar fracture (> 2 mm) is usually operated on. The aim is to stabilize the fracture and to mobilize the elbow from the start.

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