Humerus (Arm) Fractures

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What are Humerus Fractures?

A humerus fracture refers to a break in the upper arm bone, known medically as the humerus. This bone extends from the shoulder to the elbow, playing a crucial role in the movement of both these joints. Humerus fractures are a relatively common occurrence, particularly in older adults due to increased vulnerability to falls and decreased bone density.

These fractures are categorised based on their location, the pattern of the break, and whether the bone has broken through the skin (compound fracture). They can result from direct trauma, such as a fall or a direct blow to the arm, or indirectly through twisting injuries.


Humerus fractures can be caused by a variety of factors, often related to the mechanism of injury. Common causes include:

  • Falls
    Falling onto an outstretched arm or directly onto the shoulder can cause a humerus fracture, especially in older adults whose bones may be more brittle due to osteoporosis.
  • Direct Impact
    High-impact activities or accidents, such as motor vehicle accidents or contact sports, can result in a direct blow to the arm, leading to a fracture.
  • Overuse
    Repetitive stress or overuse, particularly in athletes or individuals engaging in activities involving overhead motions (like tennis or baseball), can lead to stress fractures in the humerus.
  • Pathological Causes
    Certain medical conditions that weaken the bone, such as osteoporosis, bone cancer, or similar bone diseases, can make the humerus more susceptible to fractures even with minimal trauma.

Types of Humerus Fractures

Humerus fractures vary in type based on the location of the fracture, the pattern of the break, and the severity. The main types include:

  • Proximal Humerus Fractures: These occur near the shoulder joint and are one of the more common types, especially in older adults due to osteoporosis. They can range from simple, non-displaced fractures to more complex, multi-fragmented breaks.
  • Mid-Shaft Fractures: Occurring in the middle portion of the humerus, these fractures are less common than proximal fractures and are often caused by a direct blow or a twisting force. They can be simple (clean break) or complex (the bone is broken into several pieces).
  • Distal Humerus Fractures: These fractures, occurring near the elbow, are the least common. They are often seen in conjunction with elbow dislocations and can be quite complex, involving multiple fragments.


The symptoms of a humerus fracture can vary depending on the severity and location of the fracture, but commonly include:

  • Pain: Intense pain in the upper arm or shoulder area, which may worsen with movement.
  • Swelling and Bruising: Visible swelling and bruising around the site of the fracture.
  • Limited Mobility: Difficulty moving the shoulder or elbow, depending on the fracture site.
  • Deformity: An abnormal shape or angle to the arm where the fracture has occurred.
  • Crepitus: A grating sensation or sound when the broken bone ends rub against each other.
  • Numbness or Weakness: In some cases, especially with more severe fractures, there might be numbness or weakness in the arm, wrist, or hand if nerves have been affected.

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Diagnosing a humerus fracture typically involves a combination of clinical evaluation and imaging tests. The process usually includes:

  • Medical History and Physical Examination
    The orthopaedic surgeon will gather information about how the injury occurred and the symptoms experienced. A physical examination helps to assess pain, swelling, deformity, and range of motion.
  • X-rays
    X-rays are the primary imaging tool used to confirm a fracture, providing clear images of the bone and the specifics of the break.
  • Computed Tomography (CT) Scan
    In more complex cases, a CT scan may be ordered to get a more detailed view of the fracture, especially if the fracture involves a joint or multiple fragments.
  • Magnetic Resonance Imaging (MRI)
    MRI may be used in cases where there is a concern about damage to soft tissues, such as muscles, tendons, or blood vessels, around the fracture site.

Non-Surgical Treatment

For certain types of humerus fractures, especially those that are non-displaced, non-surgical treatment may be the preferred approach. This includes:

  • Immobilisation: Using a sling, brace, or cast to keep the bone in place and allow it to heal properly.
  • Physical Therapy: Rehabilitation exercises are crucial to regain strength, flexibility, and range of motion in the arm.
  • Medication: Pain management and reducing inflammation can be achieved through prescribed or over-the-counter pain relievers and anti-inflammatory medications.

Surgical Treatment

In cases of more severe or complex humerus fractures, surgical intervention might be necessary. Surgical options include:

Internal Fixation

This procedure involves using metal plates, screws, or rods to hold the broken bone pieces together.

External Fixation

Occasionally, external frames are used to stabilise the fracture from outside the body.

Joint Replacement

Particularly in older adults with severe fractures, joint replacement surgery may be considered as a treatment option.


Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Measures

Preventing humerus fractures involves a combination of lifestyle adjustments and safety measures, particularly for those at higher risk. Key prevention strategies include:

  • Osteoporosis Management: For older adults, managing osteoporosis through a healthy diet rich in calcium and vitamin D, regular exercise, and medication can help strengthen bones.
  • Fall Prevention: Implementing measures to reduce the risk of falls, such as using non-slip mats, installing handrails, and ensuring good lighting, especially in the homes of the elderly.
  • Protective Gear: Wearing appropriate protective gear during sports or high-risk activities can help prevent fractures.
  • Exercise and Strength Training: Regular exercise and strength training can improve muscle mass and bone strength, reducing the risk of fractures.
  • Avoiding High-Risk Activities: For individuals with bone-weakening conditions or those who have previously experienced fractures, avoiding high-risk activities may be necessary.

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    Frequently Asked Questions (FAQs)

    How Long Does It Take For a Humerus Fracture To Heal?

    The healing time for a humerus fracture is influenced by factors such as the age and general health of the patient, the type of fracture, and the treatment method used. Typically, children and younger adults may heal faster due to their higher bone regeneration capacity.

    In adults, a simple fracture can take around 6 to 8 weeks to heal, while more complex fractures might take several months. Healing may be prolonged in cases involving surgical intervention or complications like non-union or infection.

    Can a Humerus Fracture Heal Without Surgery?

    Yes, non-displaced or minimally displaced humerus fractures often heal without the need for surgery. The primary approach includes immobilisation using slings, braces or casts to keep the bone in proper alignment.

    Factors influencing the decision to avoid surgery include the fracture’s stability, the bone’s alignment, and the patient’s overall health and activity level.

    When Is Surgery Needed For a Humerus Fracture?

    Surgery is typically required for a humerus fracture when non-surgical treatment is insufficient, such as in displaced fractures where bone fragments have significantly shifted, fractures involving joints that could impair function, or when there is a risk of nonunion or malunion.

    Surgery may also be necessary in cases of multiple injuries where stabilising the fracture is crucial for overall recovery.

    Is Physical Therapy Necessary After a Humerus Fracture?

    Physical therapy is an important component of the recovery process after a humerus fracture, irrespective of whether the treatment is surgical or non-surgical. The specific physical therapy regimen depends on the fracture’s nature and the patient’s overall physical condition. Consistent participation in a physical therapy program can significantly enhance the recovery outcome.

    Are There Any Long-Term Effects Of a Humerus Fracture?

    While most individuals recover fully from a humerus fracture, some may experience long-term effects. These can include persistent stiffness or reduced range of motion in the shoulder or elbow, decreased strength in the affected arm, and, in rare cases, chronic pain. Complications such as nerve damage or malunion (where the bone heals in an incorrect position) can also lead to long-term issues.

    These outcomes largely depend on the fracture’s severity, the effectiveness of the treatment, and the patient’s adherence to rehabilitation protocols. Regular follow-ups and rehabilitation can minimise the risk of long-term complications.