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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy
Conservative treatment is usually effective as the fragments are held in position adequately by the surrounding soft tissue. Neither perfect reduction nor immobilisation is necessary.
A hanging cast - shoulder to wrist with the elbow in flexion to 90 degrees - is given to protect the humerus from further trauma, and is then supported by a collar and cuff - not a sling. The combined weight of the arm and the cast applies enough traction to the fracture site to align the bony fragments. The cast is worn for 2-3 weeks and then replaced by either a shorter - shoulder to elbow - cast or a functional polypropylene brace, for a further 6 weeks. Active abduction is withheld until the fracture is united but pendulum exercises of the shoulder should be begun after 1 week. Rarely, an external fixator may be used.
Internal fixation - usually a plate and screws, or an intramedullary nail - may be advocated in:
Most fractures take from 4-6 weeks to heal but spiral fractures may take slightly longer.