The humerus is the single bone of the upper arm, extending from the shoulder to the elbow. A fracture in this bone, which accounts for up to ten percent of all fractures, can be serious due to potential damage to nearby nerves and blood vessels. Because the bone is large and strong, a break often results from significant trauma, such as a fall or a car accident. To prevent worsening the injury while awaiting professional medical attention, certain actions must be strictly avoided.
Immediate First Aid Missteps
A serious mistake is attempting to force the injured arm back into what you perceive as its normal position. Trying to straighten or realign the limb (reduction) can cause a minimally displaced fracture to become severely displaced. This manipulation risks sharp bone fragments tearing soft tissues, including the surrounding muscles, nerves, or blood vessels, which could lead to permanent damage.
Another misstep is forcefully removing clothing over the fracture site. Instead of pulling off a shirt or jacket, which causes significant movement and pain, it is safer to cut the fabric away from the arm. Also, avoid giving the injured person any food or drink if surgery might be necessary. An empty stomach is required for safe anesthesia, and consuming anything beforehand could complicate or delay an operation.
Failing to apply a temporary form of immobilization is a common first aid error. The most important initial action is to stabilize the arm against the body using a sling or splint to prevent any movement of the bone fragments. This stabilization reduces pain and guards against the broken ends causing further internal injury as the patient is transported for medical care.
Movements and Weight Bearing to Strictly Avoid
Once the arm is stabilized, strictly avoid using the affected arm for any functional activity. Even movements like reaching for an object, trying to open a door, or adjusting clothing introduce mechanical stress to the fracture site. This stress risks displacing bone fragments, increasing pain, and potentially worsening the injury.
Attempting to lift or carry any object in the injured hand or arm must be avoided. The force applied through the hand transmits directly to the humerus, jeopardizing the initial alignment of the fracture. Furthermore, movements that involve twisting the forearm or wrist, such as turning a key or rotating the hand, should be minimized.
Do not allow the arm to hang unsupported outside of a sling or immobilizer, as this causes significant pain and displacement. The weight of the lower arm and hand creates traction that pulls on the fracture, which is why a sling provides constant support. Even during simple tasks like washing, lean forward and let the arm dangle loosely without actively lifting it.
Errors in Symptom and Pain Management
Avoid relying heavily on non-prescription pain relievers, specifically non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, without consulting a doctor. While these medications reduce pain and swelling, some evidence suggests that NSAIDs may interfere with the early stages of bone healing. They can also increase the risk of bleeding, which is a concern if surgery becomes necessary.
Do not apply ice directly to the skin, as this can cause localized tissue damage or “ice burn.” When using cold therapy for swelling and pain, the ice pack must always be wrapped in a thin cloth or towel as a protective barrier. Applying heat, such as from a heating pad or hot bath, should also be avoided immediately after the injury because heat increases blood flow, which can exacerbate swelling and internal bleeding.
Another error is trying to manage pain by drinking alcohol, which is ineffective and dangerous. Alcohol can interact negatively with prescription pain medications and dull the senses, making it harder to accurately monitor changes in symptoms. Pain medication should be taken regularly as prescribed by a healthcare provider, rather than waiting for the pain to become severe.
Mistakes During Diagnosis and Recovery
One of the most concerning mistakes during recovery is ignoring warning signs that indicate potential nerve or vascular compromise. If you experience new or worsening numbness, severe tingling, or an inability to move your wrist or fingers, you must seek immediate medical attention. These symptoms can signal radial nerve palsy, a common complication of humerus fractures, or acute compartment syndrome, a serious condition where pressure builds up in the arm.
You must not prematurely remove a cast, splint, or brace, even if the pain has significantly decreased. The humerus typically requires six to twelve weeks to heal sufficiently, and removing the immobilization device too soon can lead to nonunion, where the bone fails to fuse back together. Similarly, skipping scheduled follow-up appointments with the orthopedic specialist is a serious error.
The doctor uses these appointments to take follow-up X-rays to ensure the bone is healing correctly and has not moved out of alignment. Once physical therapy exercises are authorized, skipping them is a major roadblock to recovery. Failure to participate in prescribed rehabilitation can lead to long-term stiffness, reduced range of motion, or frozen shoulder.