The humerus, also known as the humerus, is the largest in the arm and the most mobile of the long bones. It is the bone that connects the shoulder joint and the elbow joint. It consists of an upper, proximal end where the head is located, separated from the bone by a neck. The distal, inferior end has a transversely distinct articular surface.
Humerus fractures account for 3% of all skeletal fractures, with the most common at the upper end. They are more common in women, with a female:male ratio of about 2:1.
In men, mostly around the age of 30, the fracture is usually high-energy and occurs as a result of an accident or a fall from a height. Another group includes people in their 70s, mostly women, who get the fracture due to trauma from a fall resulting in osteoporotically altered bone.
Depending on the severity of the fracture, treatment approaches vary. Nearly 85% of humerus fractures are treated non-operatively. In mild non-displaced fractures, immobilization in a cast or splint is done for about 30 days. If the texture is proximal, immobilization is in an orthosis supporting the arm and shoulder joint together.
In the case of a displaced fracture before immobilization, the orthopedic surgeon performs a reposition to align the bone segments, after which immobilization in an orthosis or cast is performed to support the alignment performed. Analgesics or anti-inflammatory agents are taken initially. When fusion is demonstrated clinically or by X-ray, physiotherapy and rehabilitation are started.
If the humerus fracture is complex, usually of the distal epiphysis, surgery is performed. Metal constructs may be introduced to have proper immobilization.
A shoulder prosthesis is required for a severe fracture of the humeral head.
After the immobilization period, it is necessary to start rehabilitation measures. They are an integral part of the bone repair process and are no less important than adequate therapy.
Physiotherapy and kinesiotherapy procedures are mandatory in the rehabilitation process.
After immobilization, the shoulder feels weak and stiff. Since immobilisation itself, the joint capsule is stiffer and harder to move, so physiotherapy is an essential and integral part of treatment. The most important thing is to reduce the pain and swelling, and the next task is to increase the range of motion and the strength.
The rehabilitation program is individualized, and depending on the post-mobilization phase of the movement may include:
Physiotherapy:ultrasound, magnetic pulse field, electrophoresis.
Kinesiotherapy: massage, active exercises for range of motion of the fingers, wrist and elbow joint.
Physiotherapy:ultrasound, magnetic pulse field, electrophoresis.
Kinesiotherapy: massage, active exercises against resistance of the fingers, wrist and elbow joint, stretching techniques for increased flexion and external rotation.
Physiotherapy: Continued if necessary.
Kinesiotherapy: active exercises for the joints of the hand, exercises with light weights, exercises on and with equipment, stretching.
Combining complex exercises with modern equipment and techniques for physical therapy, medication support treatment, etc. are the best rehabilitation approach. Exercises to be performed at home should be those in which the patient is trained and has performed under the supervision of a therapist.
With early initiation of rehabilitation, recovery of function of the injured humerus is more rapid and successful to ensure return to normal performance of activities of daily living.
