Upper Arm Fracture

The humeral head is the uppermost part of the bone in your upper arm. Although any type of fall can cause this injury, a direct fall onto the shoulder or onto an outstretched arm are the most common causes of a humeral head fracture. This injury is especially common among the elderly, skaters, and cyclists.

Fractures of the humeral head can differ in size and configuration, varying from a crack to complex fractures with multiple pieces of bone fragments.

Symptoms

Symptoms from an upper arm fracture can vary greatly. One person may be incapacitated, while another can continue daily life with few constraints. Whether the fracture is large or small, shoulder pain is present because various tissue structures, such as the shoulder capsule, the bursa, tendons, and ligaments, are damaged during the fall. After a few days bruising may develop which can extend downwards from the shoulder to the upper arm.

The injury results in pain and muscle weakness, making it impossible to lift the arm. This inability to lift the arm can last from a few days to several weeks. Pain also restricts the ability to turn the arm inwards and outwards, making necessary daily activities such as dressing difficult.  Pain also makes it difficult to find a comfortable sleeping posture, disrupting sleep, particularly during the first weeks after injury.

Pain and weakness limiting arm movement can lead to shoulder stiffness. In some patients this results in a stiffening of the entire shoulder joint due to inflammation and adhesions (frozen shoulder). Not only is a frozen shoulder an annoying complication, but it also considerably delays recovery of shoulder function.

Recovery

The length of the recovery period for an upper arm fracture ranges from four to seven weeks and is largely determined by the extent of the fracture. Functional recovery of the shoulder and arm can take much longer than the time required to heal the bone. After six to seven weeks, the shoulder may still be painful and have restricted movement. This prolonged stiffness is caused by irritation of the shoulder capsule, tendons, and bursa.

Complete recovery with pain-free function can take from several months to a year after a shoulder fracture. The exercise goal is to restore normal function. For athletes, the focus is on recovery of sport-specific movements such as throwing, hitting a tennis ball, catching, etc.