Humerus Fracture Follow-up

Updated: Sep 24, 2015
  • Author: Adarsh K Srivastava, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Further Outpatient Care

See the list below:

  • Proximal humerus fracture
    • Displaced 3- or 4-part fractures frequently require surgical fixation.
    • Open reduction and internal fixation is common in young patients.
    • Humeral arthroplasty in older patients is common.
    • For nonsurgical fractures, continue sling for comfort and institute early range of motion (ROM) exercises.
    • Schedule initial follow-up visit within 1 week.
  • Humerus shaft fracture
    • Most humerus shaft fractures are treated nonoperatively with an expected union rate of 90-100%, though surgical fixation, by either intramedullary nailing or plating, is necessary if the fracture is segmental or the vasculature is compromised.
    • Use coaptation splint until immediate postfracture pain has subsided, usually within 3-7 days. Then, place the patient in a functional brace.
    • An orthopedic surgeon best addresses decisions regarding alignment, rotation, and progression to union

Further Inpatient Care

Open fractures require extensive irrigation. Administer prophylactic antibiotics, such as cephalexin or gentamicin.


Inpatient & Outpatient Medications

As with all fractures, provide adequate outpatient analgesia especially during the first few days. Narcotic analgesia may be appropriate.



See the list below:

  • Proximal humeral fracture
    • The most common complication is adhesive capsulitis. This can be prevented by the early initiation of a rehabilitation program.
    • Two-part fractures of the articular surface and 4-part fractures have a high incidence of avascular necrosis of the humeral head.
    • Repeated forceful attempts at reduction of a fracture dislocation may be associated with subsequent heterotropic bone formation.
  • Humeral shaft
    • The most common complication in humeral shaft fractures is radial nerve injury. The nerve deficit is usually a benign neurapraxia that resolves spontaneously, although recovery may take several months.
    • Radial nerve injuries associated with penetrating trauma or open fractures are likely to be permanent and usually warrant operative exploration.
    • Claessen et al conducted a study to determine the factors associated with radial nerve palsy in patients with diaphyseal humerus fracture.  Open fractures, location of fracture, and high-energy trauma were significantly associated with radial nerve palsy (84 of 325 patients [26%]).  According to the study, iatrogenic transient dysfunction of the radial nerve occurs in approximately 1 in 5 patients who are treated with lateral exposure of the humerus, in 1 in 9 patients treated with posterior exposure, and in 1 in 25 patients treated with an anterolateral exposure. [18]


See the list below:

  • Proximal humeral fractures
    • Complete union is expected at 6-8 weeks.
    • Older patients often exhibit a functional decrease in shoulder ROM.
  • Diaphyseal fractures
    • These fractures have a high rate of union.
    • Residual angulation is well tolerated because of compensation by shoulder and elbow ROM.

Patient Education

For patient education resources, see the Breaks, Fractures, and Dislocations Center, as well as Broken Arm, Shoulder Dislocation, and Broken Elbow.