Surgery for an Upper-Arm (Humerus) Fracture (Plates, Screws, or Flexible Nails)

What this surgery is

The humerus is the upper-arm bone, between the shoulder and the elbow. When it is broken and unstable or badly out of place, surgery can line it up and hold it. Depending on your child's age and the fracture, the surgeon may use flexible (elastic) nails placed inside the bone, or a plate and screws on the bone. Some breaks are protected afterward in a cast, splint, or sling/brace.

Why it was done

Surgery is used when the bone is too out of place to heal well on its own, when it broke through the skin, or when it broke into several pieces. Fixing it helps the arm heal straight and move normally.

Caring for the cast, splint, or sling and incision

• Keep any cast or splint clean and dry; wear the sling or brace exactly as directed.
• Keep any incision clean and covered as instructed; do not apply creams or lotions to it.
• Keep the arm elevated and wiggle the fingers to reduce swelling, especially the first few days.
• No bearing weight on the arm and no sports until your surgeon clears your child.

Pain control

• Acetaminophen and ibuprofen, used as directed, control most discomfort.
• Give any prescribed pain medicine exactly as directed.

Call our office right away if you notice

• Fingers/toes that are cold, pale, gray, or blue, or that your child cannot move or wiggle
• Numbness, tingling, or burning that does not get better after raising the limb
• Pain that keeps getting worse and is not controlled by the prescribed medicine and elevation
• Fever of 100.4°F (38°C) or higher, or shaking chills
• Swelling that does not go down with rest and elevation
• New weakness, or numbness/tingling in the hand (the nerves near this bone can be irritated by the injury)
• Redness, spreading warmth, swelling, or pus-like or foul drainage from the incision
• A cast or splint that becomes wet, cracked, soft, too loose, or too tight

Call 911 right away if your child has

• Trouble breathing or shortness of breath
• Chest pain
• A pale, gray, or bluish color to the lips or face that does not improve

Follow-up

Most upper-arm fractures heal in about 6–12 weeks. Your surgeon will follow healing with X-rays and guide return to activity. If flexible nails were used, they are often removed in a small later surgery once the bone is healed.

Learn more

For pictures and a family-friendly overview, see the OrthoKids resource linked on this page (OrthoKids: Internal fixation / Intramedullary nail). It is provided by pediatric orthopaedic surgeons.