How is a broken upper arm diagnosed?
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.
How is a broken upper arm treated?
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)
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