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;