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Upper limb trauma

Correct diagnosis and treatment of fractures ensures the best chance of regaining strength without compromising mobility.  

Upper limb trauma

Correct diagnosis and treatment of fractures ensures the best chance of regaining strength without compromising mobility.  

a skier and snowboarder dressed in bright green and yellow jackets standing on a snowy mountain top raising their snow equipment without symptoms of humerus clavicle elbow fractures

What is upper limb trauma?

Upper limb trauma is often characterised as bone fractures that are all local to the upper arm and shoulder area. A humerus fracture is a break in the upper arm bone between the shoulder and the elbow. An elbow fracture generally refers to a break in the tip of the elbow, while a clavicle fracture refers to a break in the collarbone. Each of these injuries is typically classified by the location of the fracture.

The common symptoms of any fracture include intense pain, swelling, tenderness, bruising, stiffness or grinding during movement, and in some cases, a visible bulge at the break site. It is not uncommon for fractures in these locations to cause other simultaneous fractures. For example, a humerus fracture may also cause a simultaneous rotator cuff injury or shoulder dislocation. Fractures at these sites are particularly common amongst young children and adults.

If you think you have fractured a bone, the first step in the process of diagnosis is a physical examination by a medical professional. In most cases, this will involve observation and manipulation of the affected area, both at rest and during movement. Depending on the location of the fracture, your doctor may also order X-rays, ultrasounds, CT scans, or MRI scans in order to get a clearer picture of the bone positions for treatment and realignment.
In most cases, non-surgical treatments are effective in healing fractures. These treatment options include non-inflammatory medication, physical therapy, and slings, braces, or plaster casts to immobilise the site of the injury. If non-surgical treatment methods aren’t enough to heal the fracture, surgical treatments like plates, screws, and pins are effective as a more permanent treatment option.
There are several factors that determine treatment outcomes for fractures. Age is a major factor, along with the location and severity, or “class”, of your fracture, the type of treatment you opt for, and your commitment to physical therapy and strength-building exercises. As a general rule, you should expect to return to regular activities within three months of treatment. However, because every case is unique, it’s important that you ask your doctor when you can resume normal activities like sport and work.

Whilst the majority of people who undergo shoulder surgery do well and are very happy with their function and result, there are risks which are specific to shoulder surgery in addition to the general risks of surgery. This includes deep infection, injury to the nerves tendons or blood vessels close to the surgical field which may require further surgery, stiffness or developing a frozen shoulder, ongoing pain, fracture of the bones and abnormal pain responses such as Chronic Regional Pain Syndrome (CRPS).

Most of these risks are low and less than 5 %, but it is important to be aware of these risks before consenting to surgery. There are also risks relating to the specific type of shoulder surgery that you are having which Dr Cheriachan will discuss with you in detail during your consultation.

The speed and effectiveness of the rehabilitation process for humerus, clavicle, and elbow fractures depends on several factors. Age is a defining factor, as young people generally heal much more quickly than others, as is the fracture location and class. During the early stages of rehabilitation, it’s important to maintain mobility in your fingers, wrist, and in some cases, your arm. Then, once your doctor approves it, you may begin strengthening exercises and physical therapy. In the weeks post-surgery, your doctor may also order X-rays to check that your bone is reforming properly.

Preparing for your visit

Dr Cheriachan consults from Norwest on Wednesdays and Blacktown on Mondays and Thursdays.

Your first visit will be used to carefully assess your condition as well as gathering all related health information. It is important that you bring all relevant documents including scans and x-rays. We also ask that you wear clothing that allows freedom of movement as your visit will include a physical examination. 

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Dr Cheriachan is a Sydney based orthopaedic surgeon specialising in shoulder, elbow and trauma surgery. 

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