Fracture of the Humerus

Michael J. Mullin, ATC, PTA
Kevin R. Stone, M.D.

INJURY:

On the uppermost, lateral aspect of the humerus is a bump called the greater tuberosity. It acts as an attachment for one of the important rotator cuff muscles, the supraspinatus, as well as a guide for your bicep tendon. It is typically injured in a fall on an outstretched arm, a "jam" into the shoulder joint, or direct impact. 


INITIAL CARE:

X-ray diagnosis is essential to rule out a displaced fracture. If not displaced, then:

Immobilization: Immobilization in a sling for 2 weeks for comfort.

Follow-up: A follow-up x-ray should be taken at 1 week post-injury to confirm stability and again at 1 month.

Icing: Ice bags, cold packs or cold therapy units can be used to ice the shoulder initially. 20 minute sessions, 3 - 5 times a day for the first 5 days aids in reducing pain and swelling.


REHABILITATION:

Motion Exercises: 5 - 10 times a day: -take arm out of sling and flex and extend elbow fully for 20-30 repetitions. Perform this smoothly and slowly.
•    squeeze shoulder blades together gently and hold for 5 sec. Repeat 10-20 times
•    squeeze putty or racquetball for a few minutes regularly to work strength and motion.
     Cardiovascular: Stationary bike and stair machine without weight on arms are okay
     immediately. Lower body workouts and uninvolved upper body also okay to initiate
     immediately


Precautions:

•    Do not try and actively abduct or lift arm out to the side for 4 - 6 weeks.
•    Avoid quick, jerky movements.
•    Do not lean on elbow on the injured side or try and push up to a sitting position for 4
     - 6 weeks.