Shoulder Case 6 History/Physical Exam

Mid-shaft fractures of the humerus often occur from a direct blow, FOOSH injury, or high velocity acceleration injury, such as pitching. Patients will complain of localized pain.

On exam, there is tenderness to palpation and ecchymosis, hematoma, or deformity at the site. For delayed presentations, the ecchymosis will have tracked more distally towards the elbow. The upper arm may appear shortened if there is significant displacement. Mid-shaft humeral fractures are often associated with other shoulder or elbow injuries, so these areas must be carefully examined. A complete neurovascular exam should be performed, as these patients are at risk for radial nerve injury.