Shaft of humerus fracture can occur in motor vehicle accidents, fall from heights or direct trauma.
The patient presents with extreme pain at the site and skeletal instability. The patient often supports his injured limb with other one to ease out pain. On examination tenderness and swelling is noted.
Other Injuries
Associated skeletal injuries elsewhere in the affected limb and other parts of body should be noted. The skin should be examined all around to not any wound. If present, its communication should be noted with the fracture hematoma.
Neurovascular injuries are not very common with fracture humers but must be looked for in every case. The vascular status of the extremity should be evaluated by palpation of distal pulses and assessment of capillary refill.
If there appears a compromise arterial Doppler examination should be done to rule out or confirmte injury.
Radial nerve is quite vunerable to injury in humeral fractures and must be evaluated speciallyalong with examination of other nerves.
Motor testing of wrist dorsiflexion and of extension of the interphalangeal joint of the thumb along with sensory evaluation over the dorsum of the hand indicates whether the radial nerve is functioning normally.
Radiography
Anteroposterior and lateral views of the diaphysis as well as views of the elbow and shoulder joints
Treatment
Majority of fractures of shaft of humerus can be managed non operatively. Operative intervention might be needed in fractures that are open or unreducible, those develop radial nerve palsy after plaster application, fractures with soft tissue incompetence and those which occur with other injuries requiring fixation.
The treatment is discussed separately
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