Occurrence and Diagnosis of Humerus Fractures

Abstract

Description

A broken humerus in the upper arm is referred to as a fracture. Symptoms might occur in the form of bruising, swelling, and pain. The person might hold their elbow due to the less strength and flexibility in their arm. Acute compartment syndrome and artery or nerve injuries are examples of complications. Other factors include illnesses like bone cancer. Proximal humeral fractures, humeral shaft fractures, and distal humeral fractures are among the several types. X-rays are typically used to confirm a diagnosis. For more information regarding proximal fractures, a CT scan may be performed.

Surgery, a splint, a brace, or slings are all effective treatments. A sling is frequently adequate for proximal fractures with alignment. Instead of surgery, a brace may be used to treat many humerus shaft fractures. Open reduction and internal fixation, closed reduction and percutaneous pinning, and intramedullary nailing are a few surgical alternatives. Joint replacement may be another option. While distal fractures sometimes have less favorable results, proximal and shaft fractures typically have satisfactory outcomes. The pain after a humerus fracture is severe, constant, and made worse by even the smallest actions. A few days later the fracture, bruising starts to show in the injured area, and swells. The skin at the fracture site usually becomes discolored as a result of the fracture. The humerus fracture will depress against itself which produces a cracking or rattling sound. There will be a loss of sensation or control in the arm below the fracture if the nerves are damaged. The patient will have a reduced pulse at the wrist if the fracture affects the blood flow. Displaced humerus shaft fractures commonly result in deformity and a reduction in the length of the upper arm. Distal fractures commonly restrict the elbow's range of motion and may also lead in deformity.

Most frequently, elderly patients with osteoporosis who fall on an extended arm sustain proximal humerus fractures. Proximal fractures from car accidents, gunshot wounds, and powerful muscular spasms brought on by an electric shock or seizure happen less frequently. Low bone mineral density, visual acuity and balance issues, smoking, and having low bone mineral density are additional risk factors for proximal fractures. After excessive throwing, such as pitching in baseball, a stress fracture of the proximal and shaft regions may occur. Physical trauma or falls are the usual causes of middle fractures. Spiral fractures are more likely to result from falls than from physical trauma to the humerus shaft. The humerus shaft may also fracture due to metastatic breast cancer. Children who have long spiral fractures of the shaft may have experienced physical abuse.

Physical trauma to the elbow area is the usual cause of distal humerus fractures. The olecranon is forced upward if the elbow is bent at the time of the trauma, which can result in a T- or Y-shaped fracture or the displacement of one of the condyles. Radiographic imaging is frequently used to provide a conclusive diagnosis of humerus fractures. For proximal fractures, X-rays can be taken from the scapular Anteroposterior (AP) view, which captures an angle-perpendicular image of the front of the shoulder region, the scapular Y view, which captures an angle-perpendicular image of the back of the shoulder region, and the axillar lateral view, which requires the patient to lie on his or her back, lift the lower half of the arm to the side. Radiographic images acquired from the AP and lateral perspectives are typically accurate in identifying humerus shaft fractures. Inability to bend the hand backwards or diminished sensation in the back of the hand is symptoms of radial nerve damage caused by a shaft fracture. Due to the patient's inability to extend the elbow due to pain, images of the distal region are frequently of poor quality. A Computed Tomography (CT) scan can reveal more information about a suspected severe distal fracture. Nondisplaced distal fractures might not be directly visible instead, they might only be noticeable when internal bleeding in the elbow has caused fat to be displaced.