Humerus fracture
This page is for adult patients. For pediatric patients, see: Humerus fracture (peds).
Background
Humerus Fracture Types
Clinical Features
- History of trauma
- Pain over fracture site
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Evaluation
Workup
Diagnosis
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Adult Humerus Fracture Management Table
| Fracture | Splint | Disposition |
| Proximal | Non-emergent, but many need surgery, refer to ortho vs ED consult | |
| Shaft |
|
R/o neurovasc injury and compartment syndrome, but many need surgery, refer to ortho vs ED consult |
| Elbow Fracture (Adult) | Long arm posterior splint | R/o neurovasc injury and compartment syndrome, but many need surgery, refer to ortho vs ED consult |
| Olecranon |
|
R/o neurovasc injury and compartment syndrome, refer to ortho within 24 hrs |