Humerus Fracture Mid-shaft - 6 weeks in

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Hello everyone. Glad to find this forum and to read about everyone’s experiences. I have found it hard to find information or pages for people going through a humerus break so I thought I would post my experiences so far.

I am a 28 year old female in Scotland. I have a mid shaft humerus fracture of my left (non-dominant) arm, which happened on 16th January 2018, so six weeks ago today. I have never broken a bone before, and I had no idea at the time what I had let myself in for. I was very much of the understanding that broken bones take around 6 weeks to heal, give or take. So apparently I chose the wrong bone to break!  I will include a brief overview of my journey so far. Please feel free to leave any comments, questions or insights smile 

Day of injury: I fell from a horse while jumping, at speed, directly onto my left arm and knew instantly it was broken. I stayed calm and told my instructor and fellow riders in an almost jovial manner that I needed help as I had broken something. At this point I had no idea how bad it was. I asked them to call my husband also and explain I may be home a little late. Luckily my husband insisted on coming along to the hospital, as I had told him not to worry and that I would just see him when I got home... Ambulance was called, I was given gas & air and morphine for the pain (I didn’t feel any pain at this point but the paramedic assured me that adrenaline and shock were involved in that and that I’d be glad to have the drugs in my system shortly). I was taken to A&E, and examined. X-ray confirmed a broken left humerus midshaft, but no nerve damage suspected. The fracture was severe on the X-ray so I was informed that an operation was likely to be required. My arm was then manipulated into the correct position and put in a splint, from shoulder to elbow. I did require the morphine and gas&air at this point! A further X-ray was completed which now showed my humerus in an acceptable position and I was therefore told no surgery required for the time being. I was sent home with strong painkillers and told to return a week later. 

Week 1 check up: X-ray showed that my humerus was now in a less favourable position than the week previous. They decided to try a brace for a week and see how it was looking. The brace was applied and the X-ray repeated, showing an acceptable position again. Sent home for a week. Having now done my own research, I believe the movement in my humerus over week one was due to having not been advised to stay upright at all times and to not rest my elbow. I had been sleeping on my side (on non-injured arm) and had often been resting my elbow on surfaces to give my neck a break from the weight of my arm.  Once I exited the hospital I felt very down for the first time, realising how long the road ahead may be. I cried for the first time today. It really hit home. 

Week 2 check up: Still happy with position of humerus. Told to begin some basic movement to try and stop elbow from seizing up too much. Asked to return the following week.

Week 3 check up: Position of humerus still acceptable. Different doctor this time. Doctor unsure whether callus was starting to show or whether just the angle of my injury on x-ray but seemed positive that all was going to plan. Asked to to return two weeks later to ensure position of humerus still acceptable. Told to start doing some shoulder movement also to prevent stiffness here.

Week 5 check up: Another new doctor. Doctor looked at my arm for first time today. Until this point no one had actually looked at it since the brace was fitted. He said from images on X-ray it was hard to tell if any healing had begun as until calcium present the X-ray won’t show it. But he felt the bone and also asked me to try and move my arm away from my body, and he seemed to think that the arm is beginning to now move as one unit, which he tells me is a good indication that healing has started. I have now been asked to return for my next check at the 8 week mark, when he hopes to have more concrete evidence of healing. He said by now the bone should be more stable in position and that the brace is more for comfort and support at this stage, therefore does not need to be too tight now. 

I am keeping everything crossed that the next X-ray will show some progress. Mentally I feel like I am coping well considering, but I miss riding and running, and driving. I would also like to get back to work but the doctor has signed me off until my next appointment. I have had some dark days where I have felt like there is no light at the end of the tunnel. I’ve had days where I have felt very isolated having no freedom to drive anywhere, and as I live in a rural area my friends are not nearby to jus pop in. I am not a talker when I am struggling so my friends had not realised how difficult things were for me. However one day I was particularly upset when one of my friends called, and she then realised how difficult a time I am having. She has been very supportive since and has taken me out a few times to cheer me up/distract me.

Sleeping has been challenging. After I read that I should be keeping upright, I started sleeping propped up with pillows. The doctor has said to me that this is not necessary however I feel that it is worth a shot if it can help. I have however now I am passed the five week point began sleeping a lot less upright, almost flat on my back. I am hopeful that the bone has enough ‘sticky stuff’ to keep it in place now. This has helped me sleep as my main issue is neck pain, with the weight of my arm hanging on it constantly, so being able to lie with the weight off my neck really has helped a bit. I have been very fortunate that I have not to date experienced much pain in my actual arm. Discomfort at times, but not pain as such. I am unsure whether this is normal? 

The only other thing I’d like to mention is that I cannot yet fully straighten my arm at my elbow however from reading others journeys I believe this is fairly normal and is something I will need to work hard on to fix. 

Sorry for the long post - I’ve struggled to find information around this other than on this forum and a couple of other pages, so I am hoping that my experience so far may be of interest to anyone else going through this now or in the future, and of course I would be interested to hear anyone else stories or inputs! 

Sam xx

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  • Posted

    Hi.  I, too, had a mid-shaft humerus fracture last May.  I was on holiday in Tenerife at the time and had to have surgery there, to insert 4 metal rods.  It was only on returning home and registering with the fracture clinic that I realised what a long haul it was going to be,even with the rods in place.  X-rays showed healing well but I still needed good physio to get my shoulder and elbow working (I also had an arm brace).  My arm was black and blue, my hand swelled up and fingers wouldn’t bend.  I’m only telling you all this so you can be reassured that this is all NORMAL for such a fracture!  After 3 months I began to drive then returned to work ( as a nurse).  I was seen in the clinic again around Christmas time, expecting to be discharged, but they told me I can have even more movement in my arm if I continued with the exercises, and will see them again in June.  Humerus fractures really are one of the worst breaks you can have and I’m afraid you will just have to be patient, until the day you can wave goodbye, like me, to all those hospital appointments!
    • Posted

      Thank you for sharing your experience, I’m glad to hear that you are back to doing normal things, it must have been a great relief to be able to drive and work again! 

      Thanks also for reassuring me that what I am going through is normal for this type of fracture, it’s such a daunting experience so that really is reassuring to hear! smile

  • Posted

    Sam, I scarcely dare tell you my story. But it sounds like you are on the road to healing so hopefully you'll have more joy than me. I broke my left humerus mid-shaft transverse last July. Tripped over my own feet playing netball and didn't bounce off the tarmac... I started writing a blog documenting my progress over the first six weeks but haven't kept it up. Lots of developments (or not) since then.

    In short, my bones refused to heal. Unlike you I stayed upright (purchased a reclining granny chair for sleeping) and I never had any sprinting or bracing. At 13 weeks (end September 2017) it was perfectly clear the bone was not going to fuse so I was put onto the list for surgery. At first they told me I wouldn't get a slot until February and I was devastated at being out of action for what would amount to effectively the best part of a year (allowing 13 weeks to sign off). I started looking into paying for private surgery. However my consultant (I'm in Surrey) suddenly came up with an opening at the end of November so almost 5 months after my accident I finally went in for ORIF. Metal plate and 4 screws to bolt the two ends of bone together. I had said I would be happy to have a bone graft from my hip if the surgeon thought it necessary but in the event they decided not to do this.

    Surgery is like throwing you back to the original fracture. I was back sleeping in the upright position, swollen all down my arm to my fingers and on strong meds. It did all improve more quickly though. A consequence of allowing my arm to hang all this time though is that by now my shoulder was wasted and my elbow unable to straighten. My fingers were also still swollen and curved round.

    At six weeks post op I had signs of callus and the registrar said he was pleased with progress. I was allowed to do range of motion physio which meant I could almost straighten my elbow and lift my arm directly out in front of me but no further.

    Last week I went back for fracture clinic and x rays 12 weeks on from ORIF. In total I am now almost 8 months post-accident. Unfortunately this time I was told there was NO improvement from 6 weeks ago. I've previously had a DEXA scan (all normal) and vitamin D blood test (slightly low but I've been taking supplements + magnesium since then). The physio was going well but now I've been told to take a step back and NO resistance, lifting, pulling or pushing. I am pretty sure I've done nothing to create this issue. It's just bad luck. The only good thing was that the registrar agreed I can run (with care), swim (with minimal resistance) and drive if I feel comfortable. I have tried and can't use a gear stick yet but am ok in husband's automatic.

    I am comfortable sleeping in bed and can sleep on both sides and on my tummy now (yay!). My left shoulder is pathetic and I can't lift my arm far in any direction. And physio has warned me not to swing it.

    Next x ray is in another 3 months. Fingers crossed for progress then!

  • Posted

    Oh - should add that with the simple physio I have had since op my elbow is now virtually straight. A little swelling still and the most gruesome grinding noise on rotation (No pain associated). Registrar said they will x ray that in 3 months if it's still doing it.

    Also on re-reading the above I realise I did have a functional velcro-fastened thermo-moulded brace during the first 4 months after first two weeks. It made me feel a bit safer and sent out a signal to other people to keep clear. I only had occasional pain if I knocked it or if the muscle suddenly shifted. I was able to sleep in bed from 8 weeks on my back. On my right from 11 weeks but was very conscious my arm was then lying on a curve. In fact even with the metal plate in this is still uncomfortable and sometimes wakes me up.

  • Posted

    i fractured 3 bones in my foot so maybe things are different.

    i find incredible that a broken arm could heal with no surgery and no cast! when they manipulated my ankle back in place it was really unstable, i could feel the bones moved when they cut off the shoe.  so i can't imagine the broken arm with no support!

    plastering proces has been very painful for me so would be great to avoid. but i experienced both the splint and the leg brace and they are not effective as a real plaster.

    this is my second fracture to the same bones and they casted my entire leg even if it's only the ankle that i fractured, i feel much better now than i did in the brace after 1st break even if this one is worse.

    • Posted

      Sounds traumatic - I hope you are well now? 

      The humerus from what I gather is treated differently to most breaks due to the location. Casts are not used for a fracture of the humerus. The brace acts like a cast and helps hold the bone in position to allow it to heal, although gravity is the most important aspect - so keeping the arm hanging vertically is the best way to get it to line up. It is unlikely that it will heal completely straight but since there is a lot of movement in shoulders and rotation in arms, this usually doesn’t impact much on function luckily smile 

    • Posted

      yes i was released yesterday, pains are minimal now that the cast is hard, i must be careful with the swelling.

      during this days i spent at bone hospital i learned that the cast is more important for the articulary fractures (ankles, elbows...) this is why my foot never healed when treated with the boot. also all the full arm casts i saw were used for broken wrists.

      still the treatment for broken humerus looks scary.

       

  • Posted

    Thanks for taking the time to document your injury and progress.

    I am at the beginning of my my recovery, having broken my proximal humerus in two places, one of which is a spiral fracture. 

    I am just over 3 weeks , in a clasby brace and still experiencing pain around the area of the breaks. 

    Sleeping upright using pillows and a travel neck pillow is the norm for me, and it’s not too bad until I slip down a bit a rest my elbow! The pain wakes me up, but juggling around I can  get comfy again. 

    I am desperately reading up on recovery times etc as we have a Overseas road trip planned in mid June (8 1/2 weeks away) and I really want to go. I am guessing i will still be in the  brace, .

    I just wondered what state you were in at around the 3 month mark post injury? 

    Am I being a total idiot in thinking I can manage and actually enjoy it? My thoughts are that I am in a brace in uk or on hols whilst I recover . 

    I won’t be doing any lifting etc as I am ins party of 4 adults , who will  do all the fetching and carrying etc and I am not a driver. 

    • Posted

      Hi Karen. 

      I’m at 11 weeks now, and I’m comfortable enough to travel in the car and on public transport and walk around a bit but still need to be careful if someone driving me around goes too fast over speed bumps etc as this can hurt! 

      Still in the brace although I’ve heard of people healing quicker than me that have been out of the brace at 12 wks as everyone heals at different rates. 

    • Posted

      Hi Sam

      Thanks for the quick response, I was feeling very isolated, but not anymore :-)

      Are you still having regular X-rays and checkups? I read that you mentioned an 8 week checkup, hope are you still progressing ok?

      Are you allowed to remove the brace or even the sling for short periods?

      So many questions, sorry, and I know we are all different and recover at different rates, I suppose I am the eternal optimist, I just want to enjoy my holiday in even a limited format and tackle the Physio on my return , hopefully. 

       

    • Posted

      Hello! 

      Yes my next check is at 12 weeks, so Thursday. They weren’t happy with my speed of healing at my 8 week appointment so I’m hoping that the X-ray on Thursday shows some progress otherwise they have suggested they may wish to operate. I’d rather avoid this if at all possible! 

      At 8 weeks they said I no longer needed to use the sling but I had to wean myself off of it over a few days as the muscles got sore and stiff very quickly being used after being immobile for so long. I was also given permission to now remove the brace for showers, but it goes straight back on after the shower.

      I’m praying my check on Thursday will be more positive. 

      I think as long as your healing goes well you’d be able to enjoy your holiday but would need to take it easy and make sure you don’t do anything that you shouldn’t. But I’m sure your doctors will be able to advise on whether they would recommend it or not. I’ve read some blogs of people with this injury who have gone travelling with it, I could probably find the link for it if you’d like to read it. Please feel free to private message me if you’d like me to find it and send it to you smile 

    • Posted

      Hi Karen. I actually doubt you will be able to go PNB tour trip.  Possibilities of damaging what had healed will be too much of a threat.  I'd like to know your decision.  Keep that arm dangling.  And good luck.. Cynthia

  • Posted

    Hi Sam and Karen,

    thank you for sharing your journeys. I broke my humerus 2 weeks ago slipping on an icy deck. I hadn’t heard of this injury before, so hearing of your journey to recovery is so helpful as I was starting to feel isolated. I hope you are both doing well.

    i have a sling and at the fracture clinic week 1 I was told to carry on doing what I was doing (which is nothing) as the bones have moved together. I’ve got an electric recliner to sleep in though I can’t sleep for long. I haven’t left the house as I walk so slowly and hold onto the arm injured arm for support. I can do most of the exercises apart from straightening from the elbow, it’s just too painful. Elbow & arm very colourful and swollen. I’m wondering if the elbow is fractured too. I am getting very bored but trying to rest. It’s not easy. Predicted return to work date is 12 weeks. 

    • Posted

      Maria.  I know you pain.  I feel the human body is a miracle.  The swelling and blood that moves around the arm and who and hand is what causes the pain. Gads all that pressure.  You have not been using a sling?  I have a love hate relationship to me sling. (Remember I have Lt have to peck text). But if researcher have this than a plate and pins.  So being still is my plan which is so hard.  Sleeping also had been my issue.  I tried the recliner.  No way.  Now travel neck brace with firm pillows sitting up under my own soft sheets with pain meds.  Four hours last night.  Yeah.  But can't get blood pressure under 170/97. 

      I'm just at 2 weeks, second x-ray in three days.   I just want to know what to expect in two more weeks.  How painful is  physical therapy.  When can I raise my arm high enough to do my own hair.  .

      When can u play golf again?

      Cynthia

    • Posted

      Hi Cynthia

      i am sorry to hear about your accident. Unfortunately this injury takes a long time to heal. It’s good you have found a way to sleep. You will get better but it takes weeks sometimes months.

      there is a very good support group on Facebook called; humerus fracture support group.

      its very supportive, if you want to join

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