Humeral fractures are common. In the UK they are the fifth commonest bone fracture. They are often the result of a fall, but can also be seen in car accidents, assaults and sports injuries. A careful history, especially regarding the date, time, place and activity is helpful in making the correct diagnosis. The presence of pain (especially with rotation), numbness and deformity should prompt the diagnosis of a fracture. Radiography has limited value in the diagnosis of fractures and should be restricted to those cases where the diagnosis is being considered clinically.
More than 80% of cases are due to child abuse and in the age groups of 5–7 years and 25–39 years. It can therefore be concluded that the incidence of fractures has increased in parallel with increasing child abuse rates. In the first 8 years after childbirth, the fracture rate has risen sharply due to the high risk of broken bones resulting from labour, particularly in young mothers. In the age groups of 5–7 and 25-39 years, the risk from falling is increased in the summer in all countries. The risk due to motor vehicle traffic accidents is also great. In older populations, the risk of breaking bones is due to osteoporosis and related disorders.
In this cohort of patients at a level I trauma center, the use of plate fixation for humeral fractures was infrequently used. Fractures requiring surgical treatment were most frequently treated with open or closed reduction and screw fixation. The complication rate was 2%, which suggests that open/closed reduction and screw fixation with plate fixation is an acceptable intervention for patients with humerus fractures.
Approximately 50.8 million injuries to the upper extremities occur annually in USA. Around 1.33 million fractures will occur from these injuries. The number of fractures in adults is higher than that in children (9.9 vs. 6.4 %). The fractures occur both in the proximal (knee/elbow and proximal humerus) and distal (scapula, foot) sites. Trauma patterns in the USA show that most (94 %) road traffic injuries and fall-related injuries occur in adult populations. The most commonly fractured bones are the proximal humerus, femur, tibia, and ankle. In men, over 50 % of fractures occur in the proximal humerus.
Signs of humeral fractures include: loss of pain, inability to resist force, decreased range of motion, radial deviation and tenderness, radial nerve deviation and subacromial swelling. Radial nerve dysfunction and swelling are also frequently associated. The radial nerve can be at risk for injury during shoulder surgery but the use of a 'tilt' position may avoid nerve injury.
With appropriate treatment, most fractures heal without permanent damage or deformity; however, with improper treatment, a fracture can rarely heal and result in permanent joint damage and deformity.
Ibuprofen is an effective treatment for pain, but it is also used for other purposes, including inflammation, fever, and fever-reducing drugs. Ibuprofen also has effects on the central nervous system, by enhancing the sensation of pain. It is unclear how ibuprofen affects fractures. We do not know whether it is safe to use ibuprofen during pregnancy or whether it might harm the baby. We also do not know if ibuprofen affects the function of the baby if it is used during the early years of life.
No evidence supports the use of paracetamol to prevent postoperative shoulder pain. If your symptoms do not improve after 4-10 days, call your doctor. When shoulder pain remains after 4-10 days, see your GP for pain relief.
The majority of the studies that have been published in journals have been small. Based upon our search results to identify relevant clinical trials, there is little evidence that there is any significant benefit from Ibuprofen use in non-arthritic conditions. However, it is clear that a large amount of research is needed to draw any firm conclusions.
Among our patients, more than 85% of fractures occurred by trauma, with a history of trauma suggestive of a significant risk factor. The most common fractures were to the clavicle or sternum. A history of falling from an upright position was the most common complaint (53%) for fractures in the humerus.
Ibuprofen appears to be well tolerated and well tolerated. However, serious side effects are rare in this patient population and may include [liver toxicity, allergic reactions, and nephrotoxicity] and those that occur are usually mild. The FDA now requires that manufacturers include these side effects on their product information labels. Ibuprofen is commonly prescribed and is considered effective at the prescribed dosage. It should be used in patients for whom it is considered and discussed in the appropriate light with an ophthalmologist or optometrist, who will monitor patient care, prescribe the drug, and advise patients of all side effects.
We have identified a surprisingly large range of problems which ibuprofen seems to often treat under its common name of "ibuprofen." Most of these conditions are unlikely, nor is there any evidence that pain relief is an important benefit of treatment with these drugs. Therefore, we recommend that ibuprofen's analgesic properties to be regarded with much less confidence than is usually done. If any other benefit of ibuprofen is of interest, it is unclear whether that benefit is clinically important. There is an emerging evidence base for the efficacy of ibuprofen against migraine.