Humerus fracture recovery

hi fractured my humerus a week ago 1/3 up from the elbow - clean break spiral fracture. the doc wants to wait a week to re x-ray to check alignment. i am in a humerus brace, not plaster, which isadjustable.  they managed to align it within 1cm, but looking at an x-ray, the bone is rotated 20-30% because i am holding my arm in asling close to my chest.

will it heal like that - 30% out of position? is it possible to adjust the brace to rotate it correctly?

Hey everybody, here's my story:
I'm a 25 year old male and broke my right humerus June 6 (3 months ago) arm wrestling.  I went to emergency right away and was put in a slab and sling.  The break was fairly clean and happened mid-shaft so they told me I probably wouldn't need surgery.

About 3 and a half months ago I got a mid-humerus fracture - car accident - and I came across this forum when  I really needed to hear some personal accounts of other people with this type of fracture. I really learned a lot, from the stories and pictures of x-rays. Thanks a lot everyone!

I spent about 10 weeks in a fibreglass cast, then 4 weeks in a humeral brace. My doc said I could finally take of the brace about 1 week ago, and I'm in physio now. I had one session so far. Not much progress on the first day, but getting there a little at a time.

I thought the physio will be straight forward - just need to get back ROM and strengthen the muscles, but it's not quite so. The doc says I've got a subluxation of the glenohumeral joint, which is a slight, temporary dislocation of the shoulder. I can actually see the difference, with the shoulder of the right arm dropped slightly lower than the other. It's also quite painful.

I did a bit of reading on it, but it seems that most other websites refer to it in relation to trauma. They also mention that onc the subluxation happens it can be a recurring problem. I was wondering if this happened to anyone else during your healing process. Did you have any shoulder dislocation? Was the physio enough to deal with the problem?

Would appreciate any help.

natusik: I think that if the arm is held in that position and the bone begins healing like that, it will mend in that position. It should be adjustible, if you can get your doc to remove the brace and readjust it, for a better alignment.

dannovision: Sorry to hear that man. I've heard that about the NSAIDs too. I hope stopping it wll help.

Interesting to read all your stories. Here's my story:

I'm a 24 year old male, 65kg. I have been lifting weights for some years now, but have a hard time to gain mass. I'm pretty muscular for my size, and I'm at about 7% bodyfat. Before I broke my arm I was benching 90kg.

I broke my left humerus armwrestling 1st May 2008. It was a very strange experience for me because it happened very early in the "match". We tried one another's strength for some seconds, you know both just putting the same amount of pressure. After some 10 seconds I decided to attack, and started to press more and more for just a few seconds. As I increased my pressure quite fast I suddenly heard a loud CRACK and felt my arm go numb, no pain initially. The other guy was scared and immediately let go. As I was the one attacking, my arm wasn't twisted backwards so much, because the other guy just passively resisted.

Anyway, I realized right awat that my arm was broken and we went to the ER. The doctor there put me in a cast which I didn't feel was holding to well, so they cut it up again and, using a live-xray machine, the doc tried to find a better position for the fractured bone. That was 10 minutes of hell. He was turning, twisting, squeezing the arm to make the two parts come a bit closer, but it was impossible. I was still just on adrenaline, no meds at all! With a new temporary cast I went home and the following day I got a brace that was much better. I was told that a operation was not needed, and I was relieved.



A few days later I saw my doctor for the first time on, an expert on the humerus, and he said that operation was not necessary. These fractures (distal third humeral fracture) heal well without operation, he said. At this point I had read pretty much about this, and after a long discussion we came to the conclusion that I was to undergo surgery. There were two main reasons I changed my mind on the surgery.

First, I didn't want my arm to be any different than it was before the accident. It is widely known that these fractures heal naturally with a rotation, as the bone parts do not rotate to get the exact position of a normal arm. I didn't want to have this rotation error on my arm, and I wanted the bone to heal straight.

Second, I didn't want to be in the brace+sling for four-five months, without even being sure that it would heal successfully.

So I had the surgery 10 days after the accident. They put in a metal plate, and nine screws (two for fixation and seven locking on the plate). The surgery was a great success, but it took 2.5hrs instead of 1hr, because they had trouble aligning the parts due to the muscles around. They called in additional nurses to help pulling the arm into correct position. After the surgery I was in great pain, and I was on heavy pills + morphine injections every 2-3 hours.



After three days I was back home, and after three more days I was back at work. Still on heavy meds though. By then my elbow was pretty stiff, and I couldn't stretch it fully. The shoulder was also pretty stiff, and I couldn't sleep on my stomach as I was used to, cause i couldn't raise the arm over my head yet. With some easy stretching every day, full range of motion was back after two-three weeks.

During the summer I had a difficult time swimming because the resistance of the water caused me pain in the whole arm. But I noticed an improvement each time I pushed it a bit further.

Now I'm back in the gym, lifting extremely light, and making a whole lot of reps, just to tire and work the muscles without putting too much strain on them yet. I can lift heavier but it hurts in a strange way, and I believe it's better to do a good rehab training so I can avoid future complications. I also see improvements in how the arm feels between my gym visits, so I'll stick to this until I gradually can reach the same weights as before.

natusik


hi fractured my humerus a week ago 1/3 up from the elbow - clean break spiral fracture. the doc wants to wait a week to re x-ray to check alignment. i am in a humerus brace, not plaster, which isadjustable.  they managed to align it within 1cm, but looking at an x-ray, the bone is rotated 20-30% because i am holding my arm in asling close to my chest.

will it heal like that - 30% out of position? is it possible to adjust the brace to rotate it correctly?

Hi natusik

A quite high angle of rotation is accepted in non-operative treatment. I read the following in Wheeless' Textbook of Orthopaedics:

   - axial malalignment:
            - upper arm will accommodate 10-20 deg of anterior angulation & 10-30 deg of varus;
            - this amount of angulation would be considered acceptable for patients w/ low to moderate functional demands;

Hi  everyone

                      I am so glad to have found this site as I have been having a really bad time, first of all I must say sorry for the spelling, here is my story,
I am of a big build I like lifting weights and I am into boxing and at 40 I like to keep going, back in Oct I was playing football for my garage when I got tackled and fell forward the snap that come as I hit the grass was very loud and my arm went up my back, I had very little pain and also could not move my right arm but could move my wrist and fingers.I was taken straight to hospital where I was told I had a unstable fracture of the right humours there put me in a sling and brace and told me to come back in 3 weeks, the pain I was in was hell I could not move with out pain and I had to go to sleep in a chair as I could not get on the bed. Think I got 2 to 3 hour sleep every night.
3 week I go back to hospital they then say there need to opp as bone was getting further apart there take me in that very same day I go down for opp at 18.30 there tell me it will take 1 hour to put nail in, I woke up at 02.00 to find it had taken 5 hours to opp on me as when there opened me up there found I had 4 fractures and need a plate and a bone graft
 

The X-Ray above shows my arm after opp also after waking up I found out that I could not move my wrist or fingers,
3 days after being let out of hospital I get a phone call at home from the hospital saying there need me to come in as there needed to see me,  I went in and the surgeon told me there needed to reopp  as something had gone wrong on first opp there had already book me in so again I went into hospital on the same day there took me down that night.

The surgeon from the first opp had put to long screws in the screws have gone through my bone and on way out cut my radial nerve in two places the second opp tried to repair damage, there change screws and tried to repair nerve.
Just been back to hospital had a EMG test consultant recons I should get about 10 to 20% movement back within 18 months anything else is a bonus,
I PUT THIS UP SO IF YOU ARE THINKING OF HAVING THE OPP AS SO YOU DONOT HAVE TO BE IN A BRACE AND SLING FOR 3 TO 4 MONTHS PLEASE PLEASE THINK TWICE 

I am 29, male, about 5'8" 215, and I have humerus surgery tomorrow...
I snapped it clean while snowboarding in colorado, and had to fly back to ct for surgery.
Obviously i'm freaked out about the surgery, but I'd like to hear about recovery...
timelines, what happened after, how long on meds/out of work, etc...

thanks
Mike

Hiyaaaaaaaaaa. I'm zan from sunny England and I am 24 years of age.  I just thought I'd let people know my humerus story.

I fractured my humerus in November 2007. It was snapped clean in half right in the middle from a slightly drunken fall in which I snapped it over the edge of a bench. I went into surgery the next day and recieved a plate with 8 screws and the tell tail long scar.

After a long and depressing recovery from the operation due to my bad reaction to the morphine I started physiotherapy weekly and saw the surgeon. Each month I was x-rayed and told the fracture was still not healing, but they were hopeful.

8 months passed with still no bone healing. After the first few months I was taken off physio but my plate got more and more loose as the screws pulled out. As it wasn't healed at all, my arm got more and more bent and the bone ends started grinding. The saving grace was the fact that after the same pain for months your body blocks it out, so I didn't need any pain killers at all although the grinding sounds made me feel sick.

After the 8 months I was booked back into surgery, our lovely health service waiting lists gave me my operation (once delayed) in mid October 2008.
During the second operation in which they took bone graft out my back and replaced the existing plate with 2 new plates (there were throwing everything at it), they discovered fluid in the bone. This fluid was grown and a week after the operation they found the bone had been infected from the first operation for over a year. At least this explained why I had not healed (I kept getting told how unusal it was of someone my age and fitness not healing).

So now it's nearly 2 months after the second operation (13 months after the original accident) and due to non-morphine based drugs and 6 weeks of very strong antibiotics it looks like it is starting to heal, although still to early to say for certain.

I have about 80% movement which I kept after moving the bent arm for a year, but I have no strength and hope to start physio again in January.

For everyone who has recently fractured their humerus, don't worry. I've had a lot of your bad luck. The humerus is a very difficult bone to heal so stick in there. The nearer your fracture to either your shoulder or elbow joint, the quicker it should be due to increased blood flow. You don't notice the plate (or plates) are there. And I've been told I should have 99.9% if not 100% strength and movement return although recovery to 100% could take from 6 months to 18 months. Knowing my luck it will be over the 18 month mark.
Just make sure you get rest, proper nutrition and don't push your physio or using arm when you aren't meant to. Instead of reducing the time to heal, it could help prematurely loosening the plate and you'll end up a long term cripple like me.

This has made me appreciate exerice and weights though, and as soon as I can I'll be hardcore exercising it up to the max... totally.

hugs and kisses,

zan

I'm a 57 yo female who found this website after I fell and fractured my right humerous 6/10/08. Recovery has been slow. I was in a sling for about 2 1/2 months (no surgery) and then began physical therapy in Sept and did it for 2 months and will most likely resume it. I dont smoke and drink very little but my age is against me. Dr says I should regain about 95% of rom. I have lots of stiffness around my break and achey forearm and hand. Stopped percoset this week and tylenol helping. Also have done acupunture and massage which has helped. No surgery and dont think I will need it although the xrays are still ugly.
 
 
 
 

same story as everyone else pretty much broken in an arm wrestle.. my friend started much better and then i gave it my all and just heard a huge crack.. stood up and said what was that.. and looked down to see my arm waving about.

its been 10 days since that x-ray and todays x-ray was still bad... i'm meant to be making a decision on surgery tonight.. its mixed views on here.. some for and some not.

i'm terrified of permanent nerve damage. but i think i need to do it

My xrays still look bad even after 6 months. My doctor didnt recommend surgery at all and I have to say, even though this healing process is slow, I'm glad so far I haven't had surgery. Surgery seems to have so many risks involved in it. But if my arm was too bad I would go ahead and do it. What I realize is that recovery from this injury is measured in very tiny babysteps. The biggest surprise for me was the amount of pain in my hand which I didnt injure at all.
 
Good luck.
 
Jaam

i am meant to go and decide today and i'm still not sure

OH MY Lord. 
Why does this look like a broken arm support group lol. hahahaha

I think I just found my answer, if you google any combination of the words "humerus fracture recovery" it sends you straight here.

Gin Rummy: Simply because you don't have evidence that something does exist does not mean you have evidence of something that doesn't exist.(from the boondocks)

Hey, I've been reading this forum for a while now...and gaining a lot.

I'm a 25 year old male, I fractured my humerus 6 weeks ago tomorrow, I was bench pressing and slipped on one side, right down on my left arm. Luckily managed to get up from it & straight to a&e.

I had a cast on for 10 days then they put a bowler U type on 4 weeks ago, which has been restrictive but supportive, the last couple of weeks I've been trying to get my forearm strength back, have been lifting it up & down and got it back. Initially the arm was so stiff/sore it was painful to do, I can also lift it out about 45 degrees and been trying to swing the shoulder joint to keep it active.

I don't feel like I've been overdoing it, as in there's no pain & I can go without the sling for periods of time now. I've been feeling better day to day.

Today I went for my X Ray & they are in a good position & I can definitely see new bone forming. I was told at the last appointment I would be having the bowler U off which I was more than excited about, as it goes up over my shoulder and is restricting and heavy, but they since said wait another 2 weeks as a brace wouldn't be strong enough.

And my doctor said not to move the elbow, but since I've been feeling better and stronger, I don't know what to do, I don't want to mess up my healing but I do want to regain the use of my arm as fast as possible! And like I say, I feel like I can. And reading here some people already on physio at this stage.

I was wondering what any survivors would recommend as I feel after  6 weeks I should be trying to get the strength back, I don't want to just leave my arm and risk it getting stiff again. But maybe I should for the next 2 weeks to be safe. I'm just fed up of not working out and restriction of movement obviously...and to get even some movement back would help.

hey david,
i'm gonna give you my advice.  take it easy for 2 weeks until you see your doctor again.  it's only been 6 weeks and you have new born forming... it took me 6 months.  You are very lucky, don't risk a greater setback.
it's easy to want to rush into building strength back in your arm but the risks far outweigh the rewards.  Next time you're in, ask your doctor what you can do for rehab.
and further down the line, once you're healed up and given the green light to workout again you'll be surprised how quickly you'll gain strength back due to muscle memory.

good luck

Hey dannovision.

Thanks for your advice, I've done just that...haven't moved it except just slightly to get the shoulder revolving a bit & it actually feels a lot stronger because of this. Great to know that gaining strength shouldn't take too long, I'll bear that in mind and just think about the bone getting healed rather than using the arm.

hi, i'm 64yo old female,broke the left humerus,proximal, one week ago, fitted for brace today.it will be with a flexible elbow part.question? how long before you think i can drive. i,m glad i found this site , it hurts like hell.
 
sue

i drove at 2 weeks.
 
jaam

Just to update at 7 weeks, I have spent the last 2 days able to walk around all day without the sling, though I do still wear it as the arm really isn't strong enough yet. I have some minor pain in my shoulder and elbow joints but this is brief after I move them, so it's lack of movement related.

I can lift it out easier but am not under Doctor's instruction...

The last week has been the most productive, I feel like I'm getting a lot more normality back, and while it is still a pain it's bareable now & hopefully should continue. That said, I haven't been moving it as much as I'd been trying in week 4-6, so would be inclined to say to people that total rest of the arm could be all the more helpful in the early stages.

Lots of luck to everyone else going through the same thing, it really is a lot more uncomfortable than people imagine and wishing speedy recoveries all round.

i was wondering how people are doing.

I fracturered my humerus new years eve arm wrestling.  I am 6ft 185 and the opponent was 6"4 285.  The match was locked for about 6-7 sec. and snap...spiral fracture with a nice chunk floating around. Jan. 5  i had surgery...15 screws and a plate.   my plate and screws are a little different Than the one on the previous page.  Longer plate that wraps to the end of elbow and shorter screws coming from dofferent angles.  I had one off the best ortho surgeons in louisiana that specialize in the arm.  I have no problems with the radial nerve.  Surgery is painful but after a few days its not too bad.

hey all.

  my name is Brian, I'm  26yrs old and I broke my humerus(left arm - middle shaft) 2 weeks ago after a nasty snowboard wipeout.  I was put in a splint immediately at the ER, with no surgery.  The following monday(2 days later), they gave me a clamshell brace.  The doctor told me I was already looking pretty good, and that the splint from the emergency room was done totally wrong.  The pain had been pretty bad for the first 4-7 days, everytime i got up or down from a chair, or rode in a car I wanted to scream.  The doctor took a second set of Xrays a week later(at day 10) and said I was within 3cm.  He told me to start bending my arm up and down as far as it would go without pulling too much on the muscles around the injury.  I went back to work as well on day 10(Monday of this week), and i was wondering about the swelling.  I had no swelling Monday morning, now my hand and wrist are really swollen.  Is this normal??

It's really important to me that this heals quick and strong!  I am a metal drummer and my speed has always been my calling card.  Loosing it is not the end of the world, as long as it heals quick and I can get back to playing and building muscle strength.  My band is on hiatus waiting for me and we were about to go on a tour.  How long before I can start hitting the skins again with my left arm?  The doctor said 8-12 weeks, but I want to make sure thats going to be long enough.  Is it safe to be slamming my arm down without full union?  Thanks to all...

Hi folks,
 
I am not a body builder but found this site and forum because like you all I fractured my humerus.  I am 51  year old female.  I had surgery in October to remove a chondro sarcoma from my right upper humerus.  I had bone graft put in to fill the cavity where the tumor had been.  All went well and I was out 8 weeks, had regained almost full range of motion and was starting on weight in PT when I screwed up.  I was leading a horse out of the barn and when he started getting a little antsy I went to pop the lead rope to quiet him down and fractured the humerus at the bone graft sight.  It was a small quick movement but apparently enough torque to cause a break.  I was in an immobilizer for 5 days.  This happened Christmas eve morning so my doc wasn't available until the next week.  He put me in a clam shell brace on Dec. 29 the following monday.  One xray showed good alignment the other, where they turn your palm upward showed a slight winging out of the break.  I have had very little pain, although as time goes on my shoulder and back get sore, I expect from lack of movement.  The creepiness factor of the bone moving around has been the hardest.  Of course going back, way back beyond square one from surgery has been very depressing and I hadn't even really grasped the whole cancer thing yet.  (I'm a breast cancer survivor as well.)
 
Anyway.  I went back to see him after 2 weeks, January 12 (almost 3 weeks since break) and he said it all looks good.  The one xray again showed good alignment and the palm up xray showed good alignment but more of a gap.  He also saw what might be some callous formation at one end of the break sight, he was cautious though as it could also be an anomaly on the xray.  He also showed me where my bone is infiltrating the bone graft  which is also good news.  I will have to wear the brace for another 6 weeks and after that he wants me wearing it when I go out where I might be jostled.  He said I could go back to work in two weeks but I plan on going back in one as it will be a short week.  He wants me to continue to wear the immobilizer rather than a sling so I guess I'll stay in that until I see him  Feb 6.  I can start doing my pendulum stuff to keep the shoulder moving and I do let my lower arm straighten at the elbow 2 or three times a day to keep it mobile.  He also said I could drive in 6 weeks.  I'm shooting for 5 as I live 35 miles from work and I want to not burden my friends for very long with rides etc.  I start PT on Jan 26.
 
That's my story.  I'll update as I progress.
 
Thanks to all of you for your stories and input.  It really helps one get through this very slow and frustrating process.

My hand was pretty swollen for the first week.  I just got back from the doctor..2 weeks post-op.  He told me to start straightening and bending my arm to keep my muscles stretched.  The arm is pretty tight.  It feels strange to go without the sling just 2 1/2 weeks after breaking it but the doctor said it was okay for the most part.  I will use the sling still for a couple more weeks until I feel more comfortable with the healing. 

joewee  you are lucky to be out of sling so quick.  I have been in immobilizer for 4 weeks and will be for next three, also in brace for 5 more weeks.   I do star PT next week so that should be better.  My best to you for quick recovery.  Do what feels best for you regarding sling.  Take care.

Hello everybody. My name's Branden and I fractured my left humerus (distal fracture that required surgery) about six weeks ago.

I've been reading since a couple days after my fracture, which occurred on December 12th. It happened while weight lifting, I was doing incline dumbbell presses when my arm just started to twist. I was going to drop the weight, but wound up not doing it because I didn't want to crush my spotters foot... The spotter who incidently wasn't paying attention. I can't blame him because I know things just happen, but I definitely won't be working out with him after I'm able to start back up.

I drove to the local hospital where they put me into minor care and discharged me almost as soon as I walked in the door with a torn muscle. No x-ray even though I told them that I heard the snap, no splint or brace. I went home and tried to sleep, but when I woke up the next morning, the arm was more swollen then it was before. Something didn't seem right, so I stopped by the hospital in the next town to see what they thought, and after the tests I was diagnosed with a broken arm. My orthopedic doctor decided to wait a week to see if the bone would heal by itself, but after followup x-rays saw that the bone twisted and would require surgery. Here's the break:
http://img293.imageshack.us/img293/8255/humerusga5.jpg

Surgery was on Christmas Eve, ended up with a steel plate going halfway up the arm, 5 screws and cables wrapping from the top because they were worried about the radial nerve. I was cleared to start moving my arm around two weeks after the surgery, and now don't need to wear the brace, although I still do when I go to class or sleep just to be careful. Starting PT next week.

For anybody who's going through it now and are reading these topics, keep your head up. It's a frustrating process but you will get through it. The pain is only temporary, it's a great feeling when you begin to feel normal again.

Anywho, thanks for reading, it feels good to put this all down. Good luck to you all, hope to hear back from you so we can bounce ideas and goals off each other.

You know, I keep hearing of people getting back to normal life faster because of surgery.  I'm surprised.  My specialist said that surgery is often a last resort because of the radial nerve.  Glad to see it's working well for people.  I on the other hand am happy not to go under the knife and I think I'm already recovering pretty well after only 3 weeks(the break was Jan 02).  I'm going to Universal in Fl on Mar 26 and hope I can ride some rides without a lot of pain.  I also just want to play my drums :(

Any surgery is a risk, my doctor wanted to put it off because of the possible infections. I don't even think he thought of the nerve until he cut, he told me later that the nerve was in a very bad place. Does your specialist have you going for x-rays every week to keep up on progress?

really frustrated. found out  yesterday found out that my arm has separated at the break (broke it 6/10/08) and i am having a plate put in tomorrow.

I'm sorry to hear that jaam, good luck to you. If you have any questions post-op let me know, my time afterwards is still very fresh in my mind.