This patient is a 67 year-old female who tripped and fell, landing on her right arm and breaking the top of the humerus (the bone of the upper arm that connects to the shoulder). The X-ray above shows a long fracture that begins up near the shoulder joint and extends down the arm (red arrow).

Fractures of the upper arm can sometimes be treated without surgery and can heal well with simple immobilization in a sling. However, healing is dependent on the position and extent of the fracture and the treatment decision must be made carefully. After seeing this patient I arranged a 3D CT reconstruction, which provides a detailed picture of the injury.

On these views it was clear that the fracture was extensive, and that surgery provided the best chance for the patient to return to full and pain-free activity. The operation for this fracture involves a plate and screws, which hold the fracture in together and allow quick healing in the correct position. After carefully reducing the fracture (returning the frragments of bone to their appropriate place), the plate is secured along the bone and the screws are placed.

An X-ray is taken during the operation to confirm the position of the bone and hardware, and in this case shows that the anatomy of the bone has been restored.

The patient spent several weeks in a sling while the bone began to heal, and was then able to return gradually to full activity. Once the healing process is complete she will be able to use the arm essentially as normal, with minimal restriction of her day-to-day movements.