![]() The soft tissue injured around a humerus fracture may be considerable. Throwing grenades during military training has a particularly high incidence of spiral fracture of the humerus! Direct twisting forces as in arm wrestling have been known to cause spiral fractures as has throwing. ![]() This can happen when the lower arm is locked or trapped in machinery and the body rotates. Twisting injuries result in a spiral fracture pattern in the shaft of the humerus. The fracture pattern is often transverse. This is a rare event but may be the first sign of the cancer in some people.įractures of the shaft of the humerus that occur from bending forces may have a short oblique pattern or may have multiple fragments.Ĭompression fractures happen when the force is primarily along the line of the bone. Pathological fractures through abnormal bone occur frequently in osteoporosis and may also happen if there is a deposit of cancer in the shaft of the humerus. Open fractures occur with high-energy impact injuries and with gunshot wounds but are much less common with lower energy events such as falls and throwing injuries. Related Document: Fast Track Physical Therapy's Guide to Shoulder Anatomyīecause of the thick layers of muscle around the shaft of the humerus, open fractures are uncommon. You cannot lift up or rotate the arm below the break. This is significant because it means that any break of the humerus interrupts the function of the arm. In adults it is virtually impossible to break the tube on one side only. There are different patterns of fracture depending on the mechanism of injury, but all involve a complete break around the entire circumference of the tubular bone. The shaft of the humerus can be broken almost anywhere along its length, although a fracture is more common at the middle of the shaft and below. In this guide we are concerned with injuries to the tubular shaft of the humerus. The upper arm is so muscular that it is quite difficult to feel the actual bone. Most of the shaft of the bone is tubular but it flattens out at the lower end. It is joined to the shaft of the bone by a region called the neck of the humerus. What structures are most commonly injured?Īt the shoulder the humerus has a rounded end (the humeral head) that forms part of the shoulder joint. what Fast Track Physical Therapy’s approach to rehabilitation is.how health care professionals diagnose these fractures.On the plus side, because it is surrounded by muscle, the bone's blood supply is excellent and it has a good reputation for healing. It takes quite a lot of force to break the humerus and this is a serious injury that almost completely eliminates the functions of the arm. Without a functioning humerus you cannot position the hand in space or use the elbow. Only the femur (thighbone) and the tibia (shinbone) are bigger and stronger. It is one of the big three bones of the body. ![]() The humerus goes from the shoulder joint to the elbow joint and must be strong enough to take a good deal of weight when you lift something or push against something. The most frequently fractured site of the humerus especially in elderly is the surgical neck which is an area of constriction distal to the tuberosities.Welcome to Fast Track Physical Therapy’s guide to adult humerus fractures. Attached to the lips of the intertubercular sulcus are the tendons of the pectoralis major (lateral), latissimus dorsi (medial), and teres major (most medial/posterior). The tendon of the long head of biceps brachii runs through this groove. The intertubercular sulcus or groove separates the two tuberosities. The greater tuberosity is given additional management considerations given the concerns regarding even minimal (3- to 5-mm or greater) displacement as this can lead to a significant compromise in patient outcomes following injury via impingement and rotator cuff dysfunction. The humeral head articulates with shallow glenoid fossa of the scapula which allows for complex dynamic range of motion in many different planes. The anatomical neck can be identified as the fused epiphyseal plate which is obliquely directed and lies proximal to greater and lesser tubercles. Other osseous elements that are relevant to proximal humeral anatomy include the bicipital groove/intertubercular sulcus, medial calcar, and insertion sites for the deltoid, pectoralis major, and latissimus dorsi muscles.
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