Humerus Shaft Fracture Fixation

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What is Humerus Shaft Fracture Fixation?

Humerus shaft fracture fixation refers to a surgical procedure to repair a fracture in the shaft (the long, straight part) of the humerus, which is the upper arm bone. This type of fracture is characterised by a break anywhere between the region just below the ball of the shoulder joint and just above the elbow joint.

The procedure is typically recommended when the fracture is complex, displaced (where the bone pieces are not aligned), or in situations where non-surgical treatments (such as casting or bracing) are deemed unsuitable or ineffective.

When is Humerus Shaft Fracture Fixation Needed?

The decision to proceed with humerus shaft fracture fixation is based on several factors:

  • Displacement of the Fracture
    If the bone fragments are misaligned (displaced), surgery may be needed to realign them properly. Non-displaced fractures, where the bone pieces remain aligned, might be treated without surgery.
  • Multiple Fractures
    When there are multiple breaks along the humerus shaft, stabilising these fractures often requires surgical fixation.
  • Open Fractures
    If the fracture is open, meaning the bone has pierced the skin, surgery is usually necessary to reduce the risk of infection and properly align the bone.
  • Non-Union or Malunion
    In some cases, a fracture might not heal correctly (non-union) or might heal in a misaligned position (malunion). Surgery may be required to correct these issues.
  • Patient Factors
    Age, overall health, activity level, and the presence of other medical conditions can influence the decision to opt for surgical fixation. For example, younger, more active individuals may benefit from surgery to ensure a quicker and more complete recovery.
  • Associated Injuries
    If there are other injuries to the arm, such as damage to nerves or blood vessels, surgical fixation might be necessary as part of a comprehensive treatment plan. The radial nerve can be injured from the fracture and lead to a wrist or finger drop, which takes time to recover.

Benefits and Risks of Humerus Shaft Fracture Fixation

  • Improved Alignment and Stability: Surgical fixation allows for precise realignment of the bone fragments, which is crucial for proper healing and restoring the function of the arm.
  • Faster Healing Process: Compared to non-surgical methods, surgical fixation can often lead to a quicker healing process, allowing patients to return to their daily activities sooner.
  • Reduced Risk of Complications: Proper alignment and stabilisation of the fracture can reduce the risk of complications such as nonunion or malunion (improper healing).
  • Surgical Complications: As with any surgery, there is a risk of complications such as infection, bleeding, or adverse reactions to anaesthesia.
  • Damage to Nerves or Blood Vessels: The humerus is in proximity to important nerves and blood vessels especially the radial nerve. Surgery carries a risk of accidental damage to these structures.
  • Hardware Issues: Sometimes, the hardware used in the fixation (such as screws or plates) can cause discomfort, or there might be a need for a second surgery to remove or adjust the hardware.
  • Limited Movement During Recovery: Post-surgery, patients may experience limited movement in their arm during the initial recovery period.

Preparing for Humerus Shaft Fracture Fixation

Preparing for humerus shaft fracture fixation involves several key steps to ensure the safety and success of the surgery:

  • Preoperative Assessment
    A thorough medical evaluation, including a review of the patient’s medical history and a physical examination, is conducted. This may include blood tests, imaging studies (such as X-rays or MRI), and assessments of any other medical conditions.
  • Medication Review
    The patient should inform their orthopaedic surgeon about any medications they are taking, including over-the-counter drugs and supplements. Some medications may need to be stopped or adjusted before surgery.
  • Fasting
    Patients are usually required to fast (not eat or drink) for a certain period before the surgery to reduce the risk of aspiration during anaesthesia.
  • Discussing Anaesthesia
    The surgical team will discuss anaesthesia options with the patient. This typically involves general anaesthesia, under which the patient is completely unconscious during the surgery.


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What Can You Expect During a Humerus Shaft Fracture Fixation?

During a humerus shaft fracture fixation surgery, the following steps are typically involved:

  • Anaesthesia: The procedure usually begins with the administration of general anaesthesia, rendering the patient unconscious and pain-free during the surgery.
  • Incision and Exposure: The orthopaedic surgeon makes an incision over the site of the fracture to access the broken bone. The size and location of the incision depend on the fracture’s location and complexity.
  • Fracture Reduction: The orthopaedic surgeon aligns the bone fragments in their proper position. This step is crucial for ensuring a good outcome and proper healing of the bone.
  • Fixation: Once the bone fragments are properly aligned, they are secured in place using surgical hardware. This may include metal plates and screws, rods, or nails. The choice of hardware depends on the fracture’s nature and the orthopaedic surgeon’s preference.
  • Closure: After the fixation is complete, the incision is closed with sutures or staples. In some cases, a drain may be placed to remove excess fluids from the surgical site.
  • Postoperative Imaging: X-rays or other imaging techniques are often used post-surgery to confirm the correct alignment of the bone and the proper placement of the hardware.

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

Postoperative Care and Recovery

After humerus shaft fracture fixation surgery, the focus shifts to recovery and rehabilitation, which are crucial for regaining the full function of the arm. Key aspects of postoperative care include:

  • Pain Management
    Pain and discomfort are common after surgery. The orthopaedic surgeon will provide pain relief medications and guidance on how to manage pain effectively at home.
  • Wound Care
    Keeping the surgical site clean and dry prevents infection. The patient will receive instructions on how to care for their wound, including when to change dressings.
  • Physical Therapy
    Physical therapy usually starts soon after surgery. It helps to restore movement, strength, and function to the affected arm.
  • Activity Restrictions
    Patients are typically advised to limit certain activities, especially those that may put a strain on the healing bone. Gradual reintroduction of regular activities is based on the healing process and the orthopaedic surgeon’s recommendations.
  • Follow-Up Appointments
    Regular follow-up appointments are necessary to monitor the healing process. During these visits, the orthopaedic surgeon will check the surgical site, assess pain levels, and review any new X-rays to ensure the bone is healing correctly.
  • Signs of Complications
    Patients should be aware of signs that may indicate complications, such as increased pain, redness, swelling, fever, or drainage from the incision site, and should contact their orthopaedic surgeon if these occur.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
Ming Lee Chua
Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.
Teo Pek Suan Diana
I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    How Long Does It Take to Recover from Humerus Shaft Fracture Fixation?

    Recovery time varies depending on the individual’s age, overall health, and the complexity of the fracture and surgery. Generally, it may take several weeks to a few months for the bone to heal sufficiently.

    Will I Need to Wear a Cast or Sling After Surgery?

    A sling or brace may be required post-surgery to support and protect the arm during the initial phase of healing. The duration will depend on the orthopaedic surgeon’s advice and the healing progress.

    Are There Any Long-Term Effects of Humerus Shaft Fracture Fixation?

    Most people recover well and regain full function of their arm. However, some may experience stiffness or reduced range of motion. Long-term complications are relatively rare but can include nerve damage or issues related to the hardware.

    Can the Hardware Used in the Fixation Cause Problems Later?

    In some cases, the hardware (like screws or plates) may cause discomfort or irritation. If this occurs, a second surgery to remove the hardware might be considered after the fracture has healed.