Causes

There are numerous causes that can lead to a fracture of the upper arm. In the foreground are injuries that are associated with a strong force being exerted on the humerus. Twisting of the upper arm can also lead to fractures of the bone.These injuries typically occur during sports or traffic accidents.

Especially when high speeds are reached, the violent effects on the bone are very high. In medicine, an injury that occurs at high speed and is followed by violence is described as a so-called “high-speed trauma”. In addition to these obvious reasons that cause a fracture of the humerus, individual diseases can also contribute to an increased probability of a humerus fracture.

Especially when osteoporosis is present, the stability of the bones is limited and fractures occur even at relatively low loads on the bones. For this reason, fractures of the upper arm, which occur after a low level of force is applied, should be precisely diagnosed in order to detect and treat systemic diseases. In rare cases, metastases of certain tumors or tumors of the bone itself can also be responsible for the fact that the humerus breaks without major injuries.

In this case, the tumor tissue spreads into the bone and restricts its stability. Typical for a humerus fracture caused by a tumor is a fracture in the middle of the bone, also known as a bone shaft fracture. The treatment of an upper arm fracture depends on the type of fracture.

In general, the first step is a targeted pain therapy to eliminate the typically severe pain associated with a humerus fracture. Depending on whether the bone fragments are displaced against each other or not, a surgical therapy must be performed. If there is only a fracture of the bone, but the two fragments still lie on top of each other and are not displaced, a conservative treatment of the injury may be sufficient.

Immobilization of the arm is particularly important here, which is usually achieved by applying a plaster cast or using a so-called Gilchrist sling. These must be worn for 4-6 weeks, depending on the age of the affected person and the type of injury, until the bone has healed and the bandage or sling can be removed. In the case of displaced bone fragments and fractures that are associated with a significant soft tissue injury, surgical intervention is usually necessary to adequately treat the injury.

The correct anatomical position of the bone fragments is essential for optimal healing and subsequent freedom from upper arm pain. There are different possibilities to treat the fracture surgically. The bone fragments can be restored with plates and screws as well as nails and wires.

Which method is used depends on the individual situation and the injury. Even after surgical treatment of the humerus fracture, immobilisation of the upper arm using a Gilchrist sling is important for optimal bone healing. Open fractures are at considerable risk of infection, which is why systemic therapy with antibiotics is extremely important.

If the soft tissue is severely injured, it may be necessary to wait with the treatment of the bone until the soft tissue has healed. If the head of the humerus is affected and the joint surface is restricted, the implantation of an artificial shoulder joint may be necessary. In the case of a fracture that runs through the joint surface, there is a high probability of the development of arthrosis, which can be prevented by inserting the artificial joint. This is also necessary if the blood supply to the joint is restricted by the fracture. The implanted plates, screws, nails or wires are removed after 12 months at the earliest, while the prostheses remain in the body for the rest of life.