A mid-shaft humerus fracture counts for approximately 3% of all fractures. It is a fracture that occurs in the midshaft of the humerus. It is also known as broken hand. Usually, it does not include the joints of the shoulder or elbow.
The humerus is a strong bone that is in the upper arm, in the middle of the elbow and shoulder. The ball of the ball-and-socket shoulder joint covers it. The hinge of the elbow joint on the bottom is also included in it.
These fractures are classified into the following three types:
1.Proximal humerus shoulder fracture
2.Distal humerus elbow fracture
3.Mid-shaft humerus fractures
Mid-shaft Humerus fractures
Generally, these fractures are the result of a direct fall. Motor vehicle collisions, sports injuries, and penetrating trauma e.g., wounds due to gunshot can cause high-energy injuries. In the case of aged patients, these fractures can occur due to the bone-weakening or osteoporosis. Patients with mid-shaft humerus fracture feel as if their arm has been detached. It is not so.
Treatment
Most of the mid-shaft humerus fractures require surgical treatment which also lessens the risks and complications. Surgical treatment is suggested in case of multiple fractures, fractures with associated injuries to nerves and blood vessels, open fractures, and also in case of non-union or when non-surgical treatment fails to heal.
A fracture brace is the most widely used treatment for a humeral shaft fracture. This fracture brace is also known as the ‘Sarmiento brace’ which is named after the physician Augusto Sarmiento who proposed this procedure of treatment. Generally, a sling or a splint is used for treating these fractures. Splint and sling are applied for a week so that swelling can be subsided which is followed by the application of a fracture brace to hold the humerus in alignment. This fracture brace resembles a clamshell. This brace allows the mobilization of the shoulder and elbow as the healing starts.
But then the surgical treatment has its complications and risks such as nerve injury and failure of the healing of the bone. Following methods are used for the operative treatment of these fractures:
Rods
An intramedullary rod or metal rod is inserted in the hollow center of the bone. Surgery is less invasive in this procedure as the main nerves that run down the arm do not interfere in this procedure.
Metal Plates
The most effective treatment of a humerus fracture is the insertion of a large metal plate along the humerus which is fixed using specific screws. Locking plates and screws required for treating these fractures are made available by orthopaedic implant manufacturers.
Healing Time and Complications
Generally, a midshaft humerus fracture, when treated non-surgically, may take 10-12 weeks. During this time, exercises of the shoulder and elbow joints should be encouraged so that the mobility of these joints can be improved.
Despite the complications such as damage to radial nerves and non-union of the fracture, the surgical treatment of these fractures is used widely as this procedure not only shortens the time of healing but also is successful in achieving adequate alignment.
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