Broken Arm (Upper) - Diagnosis and Treatment

Authored by Dr Jacqueline Payne, 16 May 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 16 May 2017

An X-ray test is used to diagnose an upper arm break (fractured humerus). It is unusual for a fracture not to show up on an X-ray test but in difficult cases you might need to have a computed tomography (CT) scan carried out as well.

If the doctors think you might have 'thinning' of the bones (osteoporosis) they might also need to arrange for you to have a special scan called dual-energy X-ray absorptiometry (DXA - formerly DEXA), which is used to help diagnose osteoporosis.

The most important emergency treatment is to keep the arm as still as possible, by using a sling, and to be given strong painkillers. Treatment then depends on which part of the upper arm bone is broken.

Break to the top of your upper arm (proximal humerus fracture)

  • 8-9 times out of 10, your arm will heal simply by being kept still using a sling or some other mechanism to keep the upper arm and shoulder from moving.
  • However, some people will need surgery to fix this type of fracture. Surgery will be needed if the ends of the broken bone have moved apart or are at an angle to one another.
  • Different operations are used:
    • The ends of the bones can be fixed by using pins that go through the skin into the bones (percutaneous fixation).
    • The ends of the bones are fixed together using screws (or a plate).
    • The very top of the humerus (humeral head) is removed and replaced with an artificial humeral head (partial shoulder joint replacement).

Break to the bottom of your upper arm (distal, intercondylar or condylar fracture)

  • Most of these kinds of fractures need to be operated on. This is because the ends of the broken bones usually move away from each other (displaced or angled).
  • If the bones haven't moved (non-displaced), it can be treated in a plaster with your elbow bent to a right angle.
  • Sometimes, before any surgery is undertaken, a doctor will inject a needle into your elbow to remove blood that has got into the joint. This can relieve the worst of the pain.

Break to the middle of your upper arm (humeral shaft fracture)

  • This type of break is usually treated in a plaster cast. After 1 to 3 weeks the plaster cast is changed to a type of brace called a functional arm brace. This is a brace which you can remove yourself to do arm exercises, as guided by a physiotherapist.
  • If the broken bones have moved away from each other, you might need to be given a brief anaesthetic so that the doctors can move the bones into a good position for healing.
  • If it is not possible to get the bones into a good position or if the bone is broken into more than two pieces, you will need an operation. The bones will be fixed together with screws or by using a piece of metal screwed across the break (a plate)

Further reading and references

  • Kim SH, Szabo RM, Marder RA; Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res (Hoboken). 2012 Mar64(3):407-14. doi: 10.1002/acr.21563.

  • Jordan RW, Modi CS; A review of management options for proximal humeral fractures. Open Orthop J. 2014 Jun 278:148-56. doi: 10.2174/1874325001408010148. eCollection 2014.

  • Wang Y, Zhuo Q, Tang P, et al; Surgical interventions for treating distal humeral fractures in adults. Cochrane Database Syst Rev. 2013 Jan 311:CD009890. doi: 10.1002/14651858.CD009890.pub2.

  • Clement ND; Management of Humeral Shaft Fractures Non-Operative Versus Operative. Arch Trauma Res. 2015 Jun 20

  • Pandya NK, Baldwin KD, Wolfgruber H, et al; Humerus fractures in the pediatric population: an algorithm to identify abuse. J Pediatr Orthop B. 2010 Nov19(6):535-41. doi: 10.1097/BPB.0b013e32833ce424.

  • Harding P, Rasekaba T, Smirneos L, et al; Early mobilisation for elbow fractures in adults. Cochrane Database Syst Rev. 2011 Jun 15(6):CD008130. doi: 10.1002/14651858.CD008130.pub2.

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