Operation of a humerus fracture

In principle, there is the possibility of conservative and surgical treatment of an upper arm fracture. For a conservative therapy (immobilization in a plaster cast), special requirements must be met: On the one hand, the two ends of the fracture must not be displaced against each other. In addition, the two ends of the fracture must not be more than one centimeter apart.

This is the case in the majority of cases of a humeral head fracture (humeral head fracture). If the above conditions do not apply, a humeral head fracture must be treated surgically. In addition to displaced, slipped and widely spaced fractures, all comminuted fractures must also be treated surgically.Furthermore, all open fractures (where the bone is visible from the outside) and fractures with injuries to soft tissue, nerves or blood vessels are treated surgically.

All fractures that involve the joint (in the case of the upper arm, the shoulder or elbow joint) must also be operated on. Such fractures would not grow together properly under a simple plaster cast without surgery and would thus lead to permanent pain and functional limitations. The situation is different for a fracture in the middle of the upper arm (humerus shaft fracture).

These fractures are mainly treated surgically. The exception are uncomplicated fractures of the upper arm shaft in children, which can often be treated conservatively. In general, the decision depends on the age of the patient, bone density, other previous illnesses and other factors, and is thus ultimately an individual decision to provide the patient with the best possible therapy.

A fracture of the head of humerus can be operated on using various osteosynthesis techniques, i.e. techniques to put the bone together. One of these is the use of transfixion wires, which can be used minimally invasive, i.e. without large incisions. So-called intramedullary nails can also be used minimally invasively.

They are placed inside the bone (medullary cavity) and fix the fragments of the upper arm from the inside. Metal plates are another option for treatment, which are used especially for fractures near joints and in children. If the head of humerus has been damaged too much, it must be replaced by a metal prosthesis.

Fractures in the area of the humeral shaft can be treated either by using a plate or an intramedullary nail. If there are several injuries, e.g. in a traffic accident, or if there is a pronounced soft tissue damage, an external fixator can also be applied. This is a wire frame that is anchored in the bone by pins and fixes the fracture ends from the outside. This frame can also be used in children.