Medical or ‘orthopedic’ treatment of a fracture of the upper end of the humerus includes:
an immobilization phase
4 weeks in general (see 6 for some cases)
– on abduction cushion concerning the potentially unstable fractures of the major tubercle (bulky fragment), this allows the relaxation of the supraspinous tendon.
– bend to the body in internal rotation (hand on the belly) for potentially unstable fractures of the minor tubercle, this allows relaxation of the subscapularis tendon.
Early and regular radiographic examinations are necessary in order to unmask any secondary displacement of the fracture (J8-J10) and then to seek the consolidation of the fracture which allows to force at the level of the reeducation.
Re-education
It starts as soon as possible, usually after the first radiographic check (J8-J10) and in the absence of displacement and until J30 so
– avoid ankylosis of the elbow, wrist and digital strings
– start a pendulum type mobilization
– perform lymhatic drainage in case of hematoma which is formed at the elbow (by gravity) and can be very painful.