Humerus Fracture: How Long does it Take to Heal a Fractured Shoulder?

What are the different types of humerus fractures?

The humerus is a bone in your arm that runs from your shoulder to your elbow. It can get fractured in different places, and the name of the fracture will depend on where the “break” happened.

Some of the different types of humerus fractures include:

• Fracture of the anatomical or surgical neck of the humerus, or cephalo-tuberosity (near the shoulder)
• Fracture of the humeral head (near the shoulder), which can be classified as type I, II, III, or IV
• Fracture of the greater tuberosity (near the shoulder)
• Shoulder or elbow intra-articular fracture (affects the shoulder or elbow joint) or extra-articular fracture (less troublesome)
• Fracture of the humeral shaft (in the middle of the bone, halfway between the elbow and shoulder)
• Proximal or upper end fracture (the part near the shoulder is affected)
• Distal or lower end fracture (the part near the elbow is broken)

And there are more!

Not only can the humerus be broken in different places, but it can also be fractured in different ways.

For example:

• humerus can be displaced or non-displaced, meaning the broken pieces are either far apart or almost touching.
• There are also comminuted fractures where the bone is broken into many small pieces.
• Open fractures are those where the skin is also broken near the fracture, which can increase the risk of infection.

These types of fractures are common in children, but in this article, we are focusing on adults.

It’s important to note that other issues can occur along with the fracture, such as dislocation, nerve or arterial damage, or damage to the brachial plexus.

In those cases, specific treatment for those issues will be necessary in addition to treating the fracture.

Humerus fractures can occur in a variety of ways and places, and they all fall under the general category of humerus fractures.

What is the treatment for a broken humerus?

A fracture of the humerus rarely goes unnoticed.

The symptoms are quite clear. Following a fall, an accident, or an impact, you will experience intense pain, and you will hardly be able to move your arm (this is called “impotence”). The upper limb is sometimes deformed, swollen, and may have a hematoma.

Generally, you will go to the emergency room when you experience these clinical signs. The doctors will decide to do an X-ray upon seeing these signs. This is where the fracture diagnosis is confirmed: an MRI or a CT scan is rarely necessary.

The X-ray is often shown to an orthopedic surgeon. These are the specialists in broken bones and injured joints!

They will decide on the treatment to follow depending on your overall health, lifestyle, the type of fracture, other problems you may have, and their own way of working!

After humerus fracture, three main treatment options are distinguished, which can be combined or used alone:

• Non-surgical fracture treatment (conservative treatment): usually with a splint, sling or brace;
• Surgery;
• Physical therapy & Rehabilitation: often done by physical therapists, sometimes by occupational therapists. Most often in a private practice or at-home physical therapy, sometimes in a rehabilitation center.

Humerus fracture treatment without surgery

Fractures of the humerus do not usually require surgery: 78% of these fractures are treated with a simple sling (Launonen 2015). In this case, you will probably be prescribed an arm sling or splint.

It will be reimbursed if you have a prescription from a physical therapist or doctor (in France).

Your medical team will tell you:

• How to put it on correctly;
• How long to wear it;
• When you can take it off during the day.

Here are some explanations to put it on correctly:

The sling has two objectives:

• To facilitate consolidation by limiting elbow and shoulder movements;
• To relieve pain.

The sling is worn 24/7 (even at night), except for when bathing and during physical therapy sessions. You need to find a balance between consolidation (facilitated by the sling) and stiffness (also favored by the ssling).

This is why a physical therapist can guide you in gradually weaning off the sling.

Usually, the sling is worn until the follow-up X-ray after 6 weeks in France. Sometimes less, sometimes more.

Most of the time, your main treatment after humerus fracture will be to limit arm movements at the shoulder and/or elbow level to facilitate consolidation. This is often done through rest and wearing a sling for a few weeks.

Surgical treatment: surgery after broken humerus

In some cases, surgery is necessary, especially if you have a displaced or comminuted fracture (in many pieces). Depending on various parameters, surgeons will most often use:

• A plate and screws;
• A nail in the bone marrow;
• An anatomical or reversed shoulder arthroplasty (in people over 65 years old, generally, as it limits shoulder movements more).

We don’t know if one type of surgical intervention is more effective than another (Cochrane 2022).

Does operating on a displaced fracture increase the chances of better recovery and a better quality of life? It is difficult to have high-quality comparative data on this subject. The data we have shows no differences in these parameters. (Cochrane 2022)

The operation is performed under general anesthesia on the same day as the fracture or in the following days.

The arthroplasty is kept “for life” unless there are problems. The same goes for plates and screws if they do not bother you.

You will probably also have an arm sling (orthopedic treatment) even if you are operated on.

In some cases, a surgeon may discuss with you the advantages and disadvantages of having surgery. It will then be up to you to decide, as only you can weigh the pros and cons in your own situation. Some people are surprised to be given this “responsibility”.

I personally think it’s great, because I believe that people are capable of making their own decisions once they are presented with the advantages and disadvantages of different scenarios.

Depending on the type of humerus fracture you have, your lifestyle, your health status, and the practices of the professionals you consult, you may or may not have surgery. The purpose of the surgery is to stabilize the fracture, and often an immobilizing brace is also used.

Physical therapy & exercise after broken humerus

Most people in France will be prescribed physiotherapy sessions after a humerus fracture. The prescription will be made either:

• immediately after leaving the emergency room or trauma service;
• or during your follow-up appointment approximately 6 weeks after the fracture.

👉 Here’s what I recommend:

• consulting a physiotherapist for an assessment in the days following the fracture;
• depending on your overall condition, the fracture, and your apprehension, the physiotherapist may suggest seeing you only in 1 or 2 weeks (or 6 weeks), more rarely 2 times per week.

Physical therapy during healing time

During the phase where you have a brace, physiotherapists will:

• answer your questions (often numerous, which is normal!);
• reassure you about any problems you are experiencing, and offer solutions. For example:
  • to relieve pain or sleep better;
  • show you what you can and cannot do during this phase, to encourage consolidation without becoming too stiff.
• Some physiotherapists will mobilize your shoulder (lifting the arm, moving it backward, to the side) from the first few days after the fracture. And show you how to do it gently and gradually yourself, sometimes several times a day. This is called early mobilization.
• Other physiotherapists will recommend that you don’t move at all during the “immobilization” period of 6 weeks. At most, they will remove the brace with you to straighten your elbow for a moment.

For my part, I discuss these 2 options with my patients. I usually recommend early mobilization as soon as they are less painful. We gradually implement this in the days or weeks following the surgery. I adapt to their pace, pain, and apprehension (or at least I try!).

The data available on the evolution of people mobilized early (within the first 3 weeks) compared to those who are not mobilized are of low quality and do not allow us to say if one way of doing things is better than another. (Cochrane 2022)

In any case, you can bend and move your fingers, hands, and wrists.

Whether or not you have had surgery, you will likely need rehabilitation sessions, often with physiotherapists. They are covered in France by social security and mutual insurance if you have a prescription from a doctor.

Physical therapy after healing

Once the consolidation is acquired, you will gradually be able to be more active with your arm. The goal is to regain the ranges of motion and strength you had before in a few weeks or months.

And most importantly, to be able to use your arm in all the activities you did before!

For my part, I perform some of the exercises I have indicated from the first few weeks starting at 4 to 6 weeks.

During the healing time of a humerus fracture, the goal is to avoid losing too much flexibility and strength in your arms (and other parts of the body). Once healing is achieved, the goal is to gradually regain the ability to use your arm as before.

What is the recovery & healing time for a humerus fracture?

“Healing time” refers to the amount of time it takes for the humerus bone to fully heal and become structurally sound after a fracture. This includes the formation of a bony callus and the regeneration of bone tissue.

“Recovery time” refers to the period after the humeral bone has healed where you are gradually regaining your normal physical abilities and strength.

Healing time after humerus fracture

How long does it take for the bones to become as strong as they were before (=healing)? This depends on many factors.

But generally, about 1 and a half months after the fracture, a bony callus has formed: this is your new bone tissue. It’s not quite like your old bone yet, but it provides good stability.

We generally say that you have healed when you have this bony callus. It can be seen on an X-ray, which is often taken 4 to 8 weeks after the fracture.

🚭 How to maximize the chances of quick and good consolidation? Consider quitting smoking or limiting your consumption.

Usually, it takes 1 and a half months for the healing to be well advanced after humerus fracture. Sometimes more, sometimes less. A follow-up X-ray can confirm this.

Recovery time after humerus fracture

Here’s a chart summarizing the different stages of recovery after a humerus fracture: displaced fracture or not, with or without surgery.

Step	Recovery time (typical range)
You have much less pain.	From a few days to a few weeks
Your bone consolidation is completed or well underway	From 6 weeks to 3 months
You no longer have any swelling or edema.	From a few days to a few weeks
You have no more need for immobilization or brace	From a few days to a few weeks
You gradually re-use your arm for eating and dressing	From a few weeks to a few months
You are able to drive again	From 2 to 4 months
You are able to start carrying weight (bags, dumbbells) with the fractured arm	From 2 to 5 months
You are able to resume all physical and sports activities from	From 3 to 8 months

After humerus fracture, most people will be able to use their arm “as before” in daily life within 3 to 6 months, sometimes more. Sports involving the use of arms will be resumed at a later stage.

Humerus fracture recovery without surgery

Recovery time for a humerus fracture without surgery can vary from a few weeks to several months, depending on the severity of the fracture and the age and overall health of the patient.

Non surgical humerus fractures generally recover faster all else being equal. Because if they did not require surgery, it is usually because they were less severe. However, the healing time remains the same: around 6 weeks.

Recovery after humerus fracture surgery

Recovery time for a humerus fracture with surgery may take longer than recovery time without surgery due to:

• additional trauma from the surgery itself;
• more severe and unstable humeral fracture.

It’s difficult to be more precise. Even though I understand that you want to know exactly how long it will take for you to recover!

Broken humerus bone in elderly: whats is the recovery time?

Fractures of the humerus particularly affect people over the age of 65. Often caused by a simple fall from their height.

The management is similar to that of adults.

The recovery time of humerus fracture in ederly may not necessarily be longer.

There is a slightly higher risk of delayed or non-union of the fracture, but it still remains rare (Green 2005).

These individuals may experience post-fall syndrome, making it harder for them to walk, stand up, and move around in the days, weeks, or months following the fall and fracture. In such cases, physical therapy aims to restore better functional capabilities.

For elderly individuals who do not have post-fall syndrome, physical therapists can also provide advice and exercises aimed at preventing the risk of falls.

Painful humerus: How long do the pains of humerus fractures last?

You’re not experiencing any pain in the days following the fracture! That’s great! Are you worried because you have pain?

ℹ️ It’s normal to be worried about pain. However, please know that it’s common in the aftermath of a humerus fracture. The pain decreases over time, at most over a few weeks.

💊 If the pain is too bothersome, it can be relieved with over-the-counter medications (such as paracetamol) or prescription painkillers (level 2 or 3 analgesics). You can also try:

• finding more comfortable positions;
• applying cold to the painful area;
• using TENS, which is more effective for acute pain than chronic pain.

The pain decreases over time. But it may flare up a bit when you start using your arm again. You’ll gradually learn how to manage your effort to recover gradually and limit the appearance of pain.

It’s common to have pain for a few days or even a few weeks after an humerus fracture. The pain can be relieved with different methods. It’s not a sign of severity, even if it’s annoying.

Driving after factured humerus: When?

There is a lack of specific recommendations regarding the safe resumption of driving after immobilization or surgery for upper extremity injuries or chronic conditions.

As a result, orthopaedic surgeons and physical therapists often rely on their own discretion or anecdotal experience instead of evidence-based clinical guidelines. This has led to a variety of opinions and protocols for determining when it is appropriate to resume driving after upper extremity injuries.

In general, it is important to wait until you have regained enough strength and range of motion in your arm to safely control a vehicle. This can take several weeks to several months.

In the United States🇺🇸, there is no federal law or regulation that specifies a timeline for driving after a fractured humerus. Instead, it is up to individual states to set their own guidelines. Some states require a doctor’s clearance before resuming driving, while others do not have any specific requirements.

In the United Kingdom🇬🇧, the Driver and Vehicle Licensing Agency (DVLA) advises that individuals with upper limb fractures should not drive until they have regained full control and strength in their affected arm.

I recommend my patients to wait until they feel comfortable before returning to driving. They should first sit in their car and see if they are comfortable using the steering wheel while stationary. Then, they can start with a 5-minute drive and gradually increase the driving time if everything goes well.

Sleeping with a broken shoulder: How to sleep well?

It’s common to have trouble sleeping when you have a humerus fracture. Here are some reasons why:

• You may be afraid of making a “wrong move” while you sleep and worsening the fracture (although this usually doesn’t happen!).
• You may have trouble finding a comfortable position. You may not be able to sleep in your usual position.
• You may be experiencing pain.

You can talk to your healthcare professionals about ways to improve your sleep. Here are some general tips:

• Sleep alone, if possible, in a large bed, so you can move more freely.
• Use pillows, body pillows, pregnancy pillows (anything you have on hand at home) to prop up your back and arm and find a comfortable position.
• Take pain medication before bed. If cold helps relieve your pain, use a cold pack at night.

What are the complications & long term effects of humerus fractures?

Don’t worry, in the vast majority of cases, people don’t experience any long-term effects from a humerus fracture.

Within a few months, you should be able to resume all your usual activities without any pain, including sports⚽🚴‍♂️🏃🏼‍♀️🎾🥊 or manual labor jobs🛠️👷‍♂️🧑‍🔧.

Possible complications (which are rare, remember) after humeral fracture include:

• delayed or failed healing (pseudoarthrosis);
• infection (especially if you had surgery or an open fracture);
• necrosis of a portion of the humerus.

Source: Chandrappa 2017

These complications are even less likely if your fracture is a simple, non-displaced one.

Some people fully regain the range of motion in their shoulder, meaning they can lift their arm all the way up to 180° again. Others may only recover 100°, 120°, or 150° of forward arm elevation, but that won’t affect their daily activities.

If you were generally optimistic and had a positive outlook on your health before the fracture, you’re more likely to have a good recovery. Source: Belayneh 2021

Most of the time, you won’t experience any complications and long term effects from your humeral fracture!