Humerus fracture

Last updated: August 2, 2023

Summarytoggle arrow icon

Humerus fractures can result from direct or indirect trauma. They are classified by location into proximal humerus fracture, humeral shaft fracture, and distal humerus fracture. Proximal humerus fractures most commonly occur in older adults, while supracondylar fractures (a type of distal humerus fracture) are most common in children. Clinical features include pain, soft tissue swelling, and visible deformity. Nondisplaced, closed fractures are typically managed with a sling or splint. If there is evidence of neurovascular compromise or in the case of open fractures, operative management is usually required.

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Classificationtoggle arrow icon

Proximal humerus fracture

Humeral shaft fracture

Humeral shaft fractures are further classified based on location. [2]

Distal humerus fracture

Distal humerus fractures, of which there are many subtypes, are a type of elbow fracture. See “Forearm fractures” for other fractures with elbow involvement.

Clinical featurestoggle arrow icon

  • Severe local pain: exacerbated during palpation or movement at shoulder or elbow
  • Local swelling (edema or bleeding), deformity, and/or crepitus
  • Shortening of the arm (associated with displacement)
  • Neurovascular complications such as radial nerve palsy (see “Complications” below)
  • See “Signs of fracture.”

The radial nerve runs through the radial sulcus of the upper arm and is especially at risk in fractures of the middle third (midshaft) of the humerus!

Diagnosticstoggle arrow icon

Clinical evaluation [2]

Any findings that suggest neurovascular injury or open fracture should prompt urgent orthopedic consultation.

Imaging [2]


Imaging for humerus fractures typically includes x-ray views of the humerus, shoulder, and elbow.

A visible anterior fat pad may be normal, but a visible posterior fat pad is always abnormal. [2]

Advanced imaging [2]

Treatmenttoggle arrow icon

Initial management by fracture type [2]

Nonoperative management

Surgical treatment

Complicationstoggle arrow icon

Humerus fracture nerve palsies
Nerve Motor function Sensory function Associated site of humerus fracture
  • Flat deltoid
  • ↓ Arm abduction at shoulder > 15 degrees
  • ↓ Sensation over deltoid and lateral arm
  • ↓ Sensation over thenar eminence and over lateral 3½ fingers (first 3½ digits, beginning with the thumb)

“Broken ARM:“ Axillary, Radial, and Median nerves can be injured.

Injuries to the median nerve and brachial artery, which both cross the elbow, are common complications of supracondylar fractures.

We list the most important complications. The selection is not exhaustive.

Referencestoggle arrow icon

  1. Walls R, Hockberger R, Gausche-Hill M, Erickson TB, Wilcox SR. Rosen's Emergency Medicine 10th edition- Concepts and Clinical Practice E-Book. Elsevier Health Sciences ; 2022
  2. Carofino BC, Leopold SS. Classifications in brief: the Neer classification for proximal humerus fractures.. Clin Orthop Relat Res. 2013; 471 (1): p.39-43.doi: 10.1007/s11999-012-2454-9 . | Open in Read by QxMD
  3. Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J. Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol. 2015; 46 (1): p.61-66.doi: 10.1007/s00247-015-3439-0 . | Open in Read by QxMD
  4. Pencle FJ, Varacallo M. Proximal Humerus Fracture. StatPearls. 2020.

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 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer