Last weeks trainwreck left my friend with a broken humerus. The neck of it, where the ball joint begins, is cracked and the ball is, too. Mildly displaced, given a 2 out of 4.
Orthopedic team at Duke told her if she was a professional athlete they would operate but since she is not, will leave it to heal on its own… Does anyone have experience with this type of break? She is getting a second opinion but I wondering what horse people have to say.
I broke my left humerus just below the head in Sept 2001. Ball was intact, thankfully (initially the techs in the ER were taking bets that I had shattered the entire head ;), so I felt lucky I didn’t have to go up to immediate surgery). It was pretty displaced initially (something about 70% displacement, I think- looked quite displaced on radiograph), but my ortho said that often my type of fracture will line up on its own if given some time. They said just based on the way my arm position is, it could line up on its own once the trauma began subsiding so they just monitored it several times a week. They said if it kept moving to realign that they wouldn’t do surgery but if it stops moving or doesn’t seem to want to be stable once the two big pieces line back up- off to the OR I would go.
I went to the ortho twice a week for over a month and was able to avoid surgery. The downside of that was that I spent a lot of time immobilized before I could do ANY PT on it so that made for some really rough rehab! But, I guess it’s better than a large rod and plate in my arm :). It also didn’t line up completely straight, so that bone is at a bit of an angle, and that arm is definitely shorter now. But, I can definitely tell that the bone remodeling over the years has worked to make it straighter :).
Either way, tell your friend to be very diligent with their rehab, and don’t be afraid to push it (as long as your Dr. says things are stable, etc). Shoulders are a bear to bring back, and it’s really “no pain, no gain”!
From a technique perspective…
As pharmgirl stated, the tendency is to end up with less motion and some degree of weakness.
This is more problematic if your discipline involves jumping as your shoulder will limit how big a release you can achieve or how much you can follow
which
will affect your rein aid.
Good luck to her.
Regards,
Medical Mike
Equestrian Medical Researcher
www.equicision.com
My 82 yo mom fractured the ball when her dog pulled her over (mom had decided that the ‘be good’ leash was optional).
It had minimal displacement but was a complex fracture.
She worked her butt off in PT after being pretty immobile for 6 wks and has MOST of her ROM back.
Friend at my barn who had to have surgery and screws didn’t get such good PT and her ROM is VERY limited.
I had a 4-part humeral fracture nearly 2 years ago, so a bit more involved than your friend’s. I had 3 surgeries (initial repair–2 screws, 4 pins; pin removal and a capsular release). It took TONS of PT to give me range of motion back. Hurts every day. Weaker than the right. I do exercises daily to keep it mobile. I am back to doing all the good stuff with horses, including jumping. I have good forward ROM, so that was never an issue for me.
Good luck! Shoulder injuries, I’ve learned, totally suck. The PT is painful.
I broke my humerus and the ball was displaced, but I do not remember to what degree in August of 2005. I had 2 surgeries on it - one to put 4 rods in and another to take them out. The worst part was that 2 of the rods were so close to the skin that they actually broke through the skin. By the end of it, I had a hole on the top of my shoulder nearly an inch in diameter with a rod sticking out about half an inch… It was nasty and the scar sucks. The other rod came out at the other end, halfway down my arm, but it didn’t make such a nasty hole. The ortho said there was nothing he could do about it and just keep everything covered and very clean.
As far as recovery, my dumb@$$ scheduled a lesson a week after the rods came out… Let’s just say I didn’t make it! :lol: My range of motion is back for the most part, but I still have pain when I do certain things and hold it in certain ways.
I was back on a horse with only one arm about 2 weeks after the surgery and riding somewhat normally after 2 months. About 4 months after the surgery during PT, my Physical Therapist said that I was doing so well that I should be back on a horse soon… She was pretty upset to find out I had been riding nearly the entire time. She never said I couldn’t… Apparently she thought it was a given…
This was taken right before the rod broke through, but you can see how it is pushing again the top of my shoulder: http://pets.webshots.com/photo/2326722260043029495FZgdzt
I have so few pics that really show my arm back then, and this was from a night on the town, so please excuse my drunk smile… At least I cropped out whatever form of hunch punch I was drinking!
I broke the humerous right below the ball also, it was displaced. My ortho rolled a small hand towel and placed it between my ribs and upper arm inside my sling which aligned the ends of the fractured bones. It healed perfectly, no surgery required.
My ortho was the main shoulder/arm guy for the Orlando magic basketball team. he said he didn’t want to do surgery if he didn’t have to as it could create significanltly longer healing time and more complications.
My friend had the same break after falling off a ladder. They also gave him a towel and it healed on its own. He was also given PT exercises to do after a month or so.
i broke my humerus at the ball. it was broken into the ball. they put me in a cast for 3 months. the cast was huge and weighted so that my arm would not heal shorter than the other one. but the huge cast also tore all my neck muscles and at some point i could not tolerate it anymore. so the put me in a shorter cast. my xrays showed healing but it never formed a bony callous. my dr was stumped. he had the orthopedic society review my case and they said it was healing but have a video xray. (high radiation exposure) it showed the bones moving. so at approx 12 weeks i had surgery. they were going to put pins and plates in but found i had formed to bony sticks holding the break in place. the dr had never seen anything like this. my muscles had been trapped in the fracture when it tried to be a compound fracture. that prevented healing all the way. they packed it with bone from my hip and it healed very quickly with no pins and plates. it was alot of PT to get my arm moving again. and now years later my shoulder is frozen. i dont have alot of range of motion. i have enough to appear normal. i am now trying to work my own PT again to get it moving better. it just it really hurts to get the stretch back. and since i dont really need it to function, its hard to do the PT to yourself.
i broke my arm at the beg of march and started riding again end of november. tell your friend good luck!!!
EqT, Sorry to respond so late. Hope your friend is better. I have had this injury, as well as a couple of friends. Originally, my doctor treated it conservatively without surgery, but I ended up w/non-union. So, ultimately I got plate and screws and it healed well. I did the physical therapy and worked with a massage therapist and have very good range of motion given the circumstances. (I wish I had had such good results with my collar bone…that sucker still has not healed). My friend’s humerus successfully healed without surgery.
FYI, my surgeon moved from DC to Cary, NC. His name is Dr. Carroll and he is great. If you need second opinion or a surgeon, definitely look him up.
Best, Susan
Posting under an alter- I’ve divulged too much info under my usual username for people to recognize me if I post this too 
I broke my humerus 5 years ago, just under the ball, complete displacement. They put a steel plate and 11 screws… honestly I felt much better AFTER the surgery.
I now have almost complete range of motion back- in fact, got it back very quickly but surgeon was amazed how fast I recovered. Limited PT. Other than an ugly scar and discomfort sleeping on that side, it doesn’t bother me, and definitely not riding.
Hope your friend has recovered well.
I broke my humerus right below the ball, not quite all the way through. The ball rotated, and got jammed up into the growth plate. (I thought I had dislocated it-I could feel a big indent where there wasn’t supposed to be one!)
I had surgery, and had 4 pins put in. Mine stuck out of my arm about 2", and looked like giant push pins, lol. I loved grossing out the boys when they would ask to see it. 
They stayed in for about a month, I had PT for a month after they came out, and tendonitis in that shoulder for about a year and a half afterwards.
I have slightly diminished range of motion, and some weakness, but nothing major. Granted, I was 14 when it broke, and 21 now, so who knows when I’m older! Haha.
I also had to have pins because of how young I was, and it would have affected the growth plate had I not.
I know this thread is a bit older, but I broke my humerus 2.5 weeks ago. Clean break in the middle of the bone. My surgeon felt the best approach would be surgery. One plate, seven screws and a five inch incision right up my arm.
2Big4Britches…I’m glad to hear you have most of your mobility back. I feel great, considering my arm was in two pieces not that long ago. I’m a bit put off by some of the other stories as the recovery seems so long.
Anyone else able to shed some light on how long it took you before you were back in the saddle? I’m open to all information, but I’m particularly interested in those who had surgery off the bat and a relatively uneventful recovery.
Thanks 
I was back on horses almost immediately, one handed, and completely without my doctor’s permission. A few months after the surgery she said I could begin riding again and was pretty ticked off to find out I had been riding nearly the entire time.
My “homeopathic hippie doctor” who is really a sports massage therapist said that I hold my left shoulder, the one I injured, tighter than my right shoulder. He said it has caused the muscles to raise down my entire left side and tense. This has lead to peroneal tendonitis, which is a pretty horrible feeling in my leg.
Wow overohunter…this was even with the physical therapy? I so want to get on just for the sake of getting it over with but God forbid I dismount unexpectedly and hurt it. To say my surgeon would be pissed would be an understatment.
In my mind, I keep thinking two months should do it. My hubby thinks four. Of course neither of us are doctors
Update on my friend: she has had a complete recovery, even with minimal PT. hope you are all doing well!
[QUOTE=comingback;6266362]
Wow overohunter…this was even with the physical therapy? I so want to get on just for the sake of getting it over with but God forbid I dismount unexpectedly and hurt it. To say my surgeon would be pissed would be an understatment.
In my mind, I keep thinking two months should do it. My hubby thinks four. Of course neither of us are doctors :)[/QUOTE]
I quit going to PT when she got mad at me for riding, so I really did not approach the situation correctly… I was 18 what can I say?
That being said, I went to PT for the first time today for my peroneal tendonitis and she said that no one’s body is perfect and everyone compensates with one side or another in different areas. She didn’t think my fall 7 years ago was as big a deal to my current issues as my homeopathic guy.
[QUOTE=EqTrainer;6266488]
Update on my friend: she has had a complete recovery, even with minimal PT. hope you are all doing well![/QUOTE]
Glad to hear it!
Overo…thanks for the info:)
Human humerus broken by horse
I have had various bone operations in my 71 years. The first was for a greenstick fracture of my right ulna or radius. Others were a collar bone, and both wrists.
But the relevant one here was caused around 1966 by a Cleveland Bay carriage horse on a walking exercise head collar taking off for home. Young, bold and brave, I thought I could hold him. But once he was in a slow canter and I was running as fast as I could, I knew I had to let go and let him go.
Alas, as I dropped the head collar rope, his left shoulder knocked against my right shoulder and threw me to the ground, with my arms outstretched in front of me.
I was in the private land of my employer, on a gravel road that had a couple of feet of grass between the edge of the road and sectional iron fencing. I had been walking the shod horse on one of the grass strips, and, while my left arm and forehead hit the gravel road, by chance my right arm found the grass.
As I lay prostrate, the horse’s left forefoot came down on my right humerus, making what turned out to be a clean break just below the upper neck. Had my arm been on the gravel, I hate to think what sort of a mess some three quarters of a ton of Cleveland Bay would have made of the bone.
The horse cantered back to the stables, and I walked back.
Rather than actual pain, I felt intense heat in my upper arm, and tried to cool it with cold water.
At the hospital, I was put out while the fracture was reduced, and I left after a day or so, with a strap round my right wrist holding it tight against my left shoulder.
I was told that there was no way the arm could be plastered, and that I would have to keep my right arm as still as possible for the next six to eight weeks.
Well, being right handed, I broke that rule fairly soon, if only to record my progress.
By the time I began physiotherapy, I had lost all strength in the arm and could barely lift it forward forty-five degrees from the vertical. I had a beast of a woman physiotherapist who by cajoling and ordering me got me, lying on my back on a mat against gym wall bars, eventually to raise my arm so my hand touched the bars. As I improved, I drove myself in a heavy Rover car to and from the clinic.
It took a couple of years before I could raise my right hand behind my back as high as I could raise my left. But I was working again with horses a few months after the accident.
But not carriage horses - just hunters.
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