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.
Proximal humerus fracture
- Proximal humerus fractures are common in older adults and typically occur between the major segments of the proximal humerus. 
- Neer classification: Fractures are classified as one- to four-part fractures, depending on the number of displaced fracture segments. 
Humeral shaft fracture
Humeral shaft fractures are further classified based on location. 
Distal humerus fracture
- Supracondylar fracture
- Transcondylar fracture
- Intercondylar fracture
- Condylar fracture
- Epicondylar fracture
- Capitellum fracture
- Trochlea fracture
- 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 “.”
Clinical evaluation 
- Skin exam: Evaluate for laceration, tearing, and tenting.
- , fracture fragments, displacement, angulation, and/or dislocation
- Visible fat pads in elbow views suggest an intraarticular fracture.
- Posterior fat pad sign: a radiographic finding caused by an elbow joint effusion; results in the presence of a lucent crescent in the olecranon fossa on a lateral x-ray view of the elbow
- Anterior fat pad sign (sail sign): a radiographic finding caused by an elbow joint effusion; results in the presence of a convex lucent crescent in the coronoid fossa on a lateral x-ray view of the elbow
Advanced imaging 
Differential diagnosis of proximal humerus fractures 
- Shoulder dislocation
- Acromioclavicular joint separation
- Clavicle fracture
- Scapula fracture
- Rotator cuff injury
- Soft tissue injury
Differential diagnosis of distal humerus fractures 
- Olecranon fracture
- Radial head fracture
- Elbow dislocation
- Radial head subluxation
- Soft tissue injury
The differential diagnoses listed here are not exhaustive.
Initial management by fracture type 
- All patients: Initiate , including analgesia.
- Proximal humerus fractures
- Humeral shaft fractures
- Distal humerus fractures
- Nonoperative management is generally possible for nondisplaced, closed fractures.
- Devices include hanging-arm casts, coaptation splints, and arm slings
- See also: “Conservative treatment of fractures”
- Fractures that commonly require surgical treatment include:
- Operative techniques depend on fracture location and type and include:
- Proximal humerus fracture
- Distal humerus fracture
|Humerus fracture nerve palsies|
|Nerve||Motor function||Sensory function||Associated site of humerus fracture|
|Axillary|| || |
- See ““ and “.”
“Broken ARM:“ Axillary, Radial, and Median nerves can be injured.
We list the most important complications. The selection is not exhaustive.