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Concept
Humerus fracture
Résumé
A humerus fracture is a break of the humerus bone in the upper arm. Symptoms may include pain, swelling, and bruising. There may be a decreased ability to move the arm and the person may present holding their elbow. Complications may include injury to an artery or nerve, and compartment syndrome.
The cause of a humerus fracture is usually physical trauma such as a fall. Other causes include conditions such as cancer in the bone. Types include proximal humeral fractures, humeral shaft fractures, and distal humeral fractures. Diagnosis is generally confirmed by X-rays. A CT scan may be done in proximal fractures to gather further details.
Treatment options may include a sling, splint, brace, or surgery. In proximal fractures that remain well aligned, a sling is often sufficient. Many humerus shaft fractures may be treated with a brace rather than surgery. Surgical options may include open reduction and internal fixation, closed reduction and percutaneous pinning, and intramedullary nailing. Joint replacement may be another option. Proximal and shaft fractures generally have a good outcome while outcomes with distal fractures can be less good. They represent about 4% of fractures.
After a humerus fracture, pain is immediate, enduring, and exacerbated with the slightest movements. The affected region swells, with bruising appearing a day or two after the fracture. The fracture is typically accompanied by a discoloration of the skin at the site of the fracture. A crackling or rattling sound may also be present, caused by the fractured humerus pressing against itself. In cases in which the nerves are affected, then there will be a loss of control or sensation in the arm below the fracture. If the fracture affects the blood supply, then the patient will have a diminished pulse at the wrist. Displaced fractures of the humerus shaft will often cause deformity and a shortening of the length of the upper arm. Distal fractures may also cause deformity, and they typically limit the ability to flex the elbow.
Source officielle
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