What is an arm fracture?
An arm fracture or broken arm is the term for any break in the humerus bone also known as the upper arm bone. The upper portion of the humerus connects to the scapula (the shoulder blade) to form the shoulder joint and the ulna and radius bones of the forearm hook onto the lower portion of the humerus to form the elbow joint. Any break in the humeral bone between these two joints is classed as an arm fracture. The location of the injury will depend on the cause of the fracture but normally fractures occur at the top of the humerus at the neck of the humeral head, the shaft of the humerus (the long portion in the middle) and over the condyles or epicondyles of the elbow joint.
Arm fractures can be classed by the severity of the break. A simple or closed fracture is a straightforward break with little damage to the surrounding muscles or nerves. A compound or open fracture which is a complicated break with damage to the surrounding skin and tissues. A comminuted fracture is when the bone has broken into several pieces and a hairline fracture is a minor crack to the bone.
Why and when do arm fractures happen?
Arm fractures are normally the result of a direct traumatic impact to the arm or from traumatic falls. Falling on your side and directly landing on the arm or falling onto an outstretched hand are the most common causes. It is instinctive to put your hands out to save yourself when you fall but this means that your hand impacts the hard floor with your body weight behind it. The sudden force and pressure that travels up the arm can be great enough to cause a fracture. A direct blow to the arm from being hit by a bat or stick or during contact sports may cause a great enough impact to fracture the humerus. Many falls from horse riding or cycling result in landing on your shoulder or arm resulting in a fracture. Fractures from mild knocks or falls may occur but this normally only happens in the presence of a bone weakening condition like osteoporosis.
What do arm fractures feel like?
An arm fracture from trauma causes a very intense immediate sharp pain around the fracture site in the arm. The sharp pain often radiates up into the shoulder and neck and down into the forearm and hand. The fracture is often accompanied by swelling and bruising and in certain cases there will be obvious deformity with a portion of bone lifting the skin up. Due to the fracture the arm will be incredibly painful to use causing the patient to hold or cradle their arm across their body. The intense pain after a break will last for several hours or days which will be aggravated or prolonged by any treatment options like manipulation or traction. Post-surgery or after treatment when the bone starts to heal there will be a dull continuous ache from the swelling and healing process that will last weeks to months. During the healing process the bone is trying to knit together and re-unite, this stage can be quite painful and it is very important to rest through this stage to ensure that the bone reconnects properly. The soft tissue surrounding the fracture also starts to form scar tissue to bind everything together allowing the structure to try and restore its original state and function.
How are arm fractures diagnosed?
Patients may be taken to A&E and a full examination will be done to rule out any additional injuries or complications like nerve or arterial damage. Your doctor will order an X-ray of the arm or shoulder to confirm the diagnosis and identify the exact location and extent of the fracture. Occasionally, if the fracture isn’t fully visible on an X-ray then an MRI or a CT scan will be ordered as this will give a more detailed view of the fractured site. Doctors may also use an MRI scan to assess whether the pain felt after trauma is coming from injury to the nearby shoulder and elbow joints and not indeed from a fracture. The occurrence of an arm fracture from mild trauma may prompt doctors to investigate for any underlying bone weakening conditions like osteoporosis.
What treatment options are available for arm fractures?
The treatment options and healing times for arm fractures vary depending on the position of the fracture and severity of the break and also on the complications from any additional injuries like nerve damage or infection with open fractures. If a portion of the humerus has displaced and completely broken away then the doctor will opt for surgical reduction and fixation to reunite and stabilise the fracture. A cast or splint will be used to immobilise the effectedarm until the fracture is well healed. In less severe cases where the bone is still in alignment the doctor will most likely opt for a conservative treatment using a cast to immobilise the arm and instructing patients to rest and avoid using the effected arm completely whilst recovering. The doctor will most likely prescribe anti-inflammatory medication and painkillers for pain relief and to reduce any swelling. An arm fracture can take anything from 6-8 weeks to heal, if not longer for more severe breaks. Patients will be referred through to a physiotherapist who will provide exercises to strengthen the shoulder and arm to aid the healing process. Fluctuating pain levels will be experienced throughout the healing process however most of the discomfort towards the end of the healing process comes from stiffness levels caused by long term immobility. The rehabilitation exercises as well as massage and some manipulative therapies can aid in recovering your shoulder and arm strength and flexibility.