This is a basic article for medical students and other non-radiologists
Humeral shaft fractures are readily diagnosed and do not usually require internal fixation.
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Reference article
This is a summary article. For more information, you can read a more in-depth reference article: humeral shaft fracture.
Summary
-
anatomy
- normal humerus
-
epidemiology
- 3-5% of fractures
- bimodal age/sex distribution
- younger male patients often have a high-energy mechanism
-
presentation
- pain, reduced motion and the shoulder and deformity
-
pathophysiology
- direct blow (transverse fracture)
- fall or twisting, e.g wrestling (oblique or spiral)
-
investigation
- an x-ray is all that is required for diagnosis and follow-up
-
treatment
- usually, operative treatment is not required
- healing is usually uncomplicated
- complications include non-union and angulation
Radiographic features
Fractures are unevenly distributed along the humeral diaphysis:
- proximal third: 30%
- middle third: 60%
- distal third: 10%
Plain radiograph
Transverse fractures are usually trivially easy to identify. Oblique or spiral fractures may be difficult to identify in a single view. Make an assessment of angulation, translation and shortening. The whole bone should be reviewed to assess the extent of the injury.