Humeral shaft fracture (summary)

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This is a basic article for medical students and other non-radiologists

Humeral shaft fractures are readily diagnosed and do not usually require internal fixation.

Reference article

This is a summary article. For more information, you can read a more in-depth reference article: humeral shaft fracture.

Summary

  • anatomy
  • epidemiology
    • 3-5% of fractures
    • bimodal age/sex distribution
    • younger male patients often have a high-energy mechanism
  • presentation
    • pain, reduced motion and the shoulder and deformity
  • pathophysiology
    • direct blow (transverse fracture)
    • fall or twisting, e.g wrestling (oblique or spiral)
  • investigation
    • an x-ray is all that is required for diagnosis and follow-up
  • treatment
    • usually, operative treatment is not required
    • healing is usually uncomplicated
    • complications include non-union and angulation

Radiographic features

Fractures are unevenly distributed along the humeral diaphysis:

  • proximal third: 30%
  • middle third: 60%
  • distal third: 10% 
Plain radiograph

Transverse fractures are usually trivially easy to identify. Oblique or spiral fractures may be difficult to identify in a single view. Make an assessment of angulation, translation and shortening. The whole bone should be reviewed to assess the extent of the injury.

Medical student radiology curriculum