Disadvantages include irritation of the patient's axilla and the potential for splint slippage. This is a stretching exercise for elbow flexors and extensors groups of muscles. Metal implants are not meant to be a long term Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. At Another Johns Hopkins Member Hospital: Ankle Fracture Open Reduction and Internal Fixation, Tibia/Fibula Fracture Open Reduction and Internal Fixation, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, fixation of the fracture fragments with plates, screws or pins, Femur Fracture Open Reduction and Internal Fixation. %PDF-1.6 % Most frequently, fractures are a result of trauma, such as a fall, motor vehicle accident, or motorcycle accident. midshaft fractures resulting in radial nerve damage. that extends from the shoulder and extends all the way to the forearm, and at the same time, it holds the elbow in 90 It typically doesn't involve the shoulder or elbow joints. This is a special situation that needsa different treatment approach altogether and it is beyond the scope of this post. However, the stiffness is not restricted to the elbow, in most cases I have found that it also affects the wrist and shoulder joint. physicians, massage therapist, dietitian, craniosacral therapists and personal Exercises for Increased Shoulder Flexibility, Deutsches Arzteblatt International: "The Treatment of Proximal Humeral Fracture in Adults", American Physical Therapy Association: "Physical Therapist's Guide to Proximal Humerus Fractures", Geriatric Orthopaedic Surgery & Rehabilitation: "Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient", Mammoth Orthopedic Institute: "Rehabilitation Guidelines for Proximal Humerus Fracture (Non-Operative)". endstream endobj startxref In a shaft of humerus fracture case, immediately after the removal of plaster cast the most important secondary complication is elbow joint stiffness. Hold the opposite end of the band in your hand with your elbow bent to 90 degrees. You have sustained a fracture to the middle portion of your humerus (upper arm bone). Stand with your non-injured arm supported on a counter or table. 4 0 obj Mid-shaft humerus fractures may be treated with: 1. Physical Therapy Prescription Humerus Fracture ORIF Patient Name: Today's Date: Surgery Date: Diagnosis: s/p ( LEFT / RIGHT ) HUMERAL SHAFT FRACTURE ORIF RECOVERY / RECUPERATION PHASE: WEEKS 0-6 __ Restore full ROM __ Modalities, Cryocuff / Ice, prn . Fractures of the humerus are divided into three types: A mid-shaft humerus fracture represents about 3% of all broken bones. A mid-shaft humerus fracture occurs when there is a direct blow to the upper arm. Dowel exercises allow your uninjured shoulder to assist movement of your injured arm. Do it 3 to 5 times in a single session. Read the benefits of regular deep tissue release therapy here. Bend and straighten your elbow so you feel a mild to moderate stretch. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. 2 Usually, the fracture is treated in a splint or sling for a week to allow swelling to subside, and then you're fitted with a fracture brace. Hold for two to three seconds; then slowly lower back down. 0300 131 4500, Bexhill Hospital Top Exercises & Stretches After Healed Shoulder Fracture (Humerus, Scapula, or Clavicle) Bob & Brad 4.63M subscribers Subscribe 3.4K Share 199K views 4 years ago "Famous" Physical Therapists Bob. This is a stretching exercise for the wrist and our starting position would remain the same. The purpose of this study was to evaluate a series of humeral shaft fractures treated with plate osteosynthesis regarding the effect of the approach and plate location on the healing rate and occurrence of complications. trainerswho specialize in orthopedic, sports and musculoskeletal conditions (basically bones, muscles, joints, tendon and ligament pains) to work collectively together to get you and your loved ones to 100%. If surgery is not required, your physician and physical therapist . > Blog It is cylindrical in shape with slightly flat on the proximal (upper) part and conical on the distal (lower) part. Pingback: What is frozen shoulder: 3 Stage & Physiotherapy to Ease Pain - Physiosunit, Pingback: Fracture humerus classification and causes - Physiosunit, Pingback: How to Loosen Tight Shoulders? However, it is important to maintain movement. Bend it to 90 degrees. to support and move the broken arm. Rehabilitation will continue until the muscles, ligaments and other soft tissues perform normally. My name is Nigel Chua, I'm the CEO and a principal hand therapist by training; my wife is Louise, she's the founder-COO and principal physiotherapist of Phoenix Rehab - and we're here to serve you. You will be fitted with a brace and a sling. 2014;37(3):e307e312. Phase-2: Week 3 to 6 of reduction of distal humerus fracture. Having regular deep tissue and sports massagewill keep your muscles healthy and fit with body/movement-confidence. Approximately 90% of humeral shaft fractures unite (heal) Radius and ulnar shaft fractures, also known as adult both bone forearm fractures, are common fractures of the forearm caused by either direct trauma or indirect trauma (fall). General andconditions. A humerus (or humeral) fracture is refers to a break in the bone We will help you get started with active exercises for the elbow, Conservative management is the treatment of choice for most humeral shaft fractures . depending on the location and direction of the break and the associated Squeeze the ball as hard as possible without pain. 150 0 obj <>stream PHASE IV: RETURN TO FUNCTION . Try to do them 4-5 times a day. Your hand should be supported higher than your elbow. Keeping your elbows straight, slowly raise your arms up toward the ceiling as far as you comfortably can. Nonunion can happen for a number of reasons. you have an open fracture you will be given additional antibiotics to A fracture in this area can be very painful and make elbow motion difficult or impossible. A proximal humerus fracture is when All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB). The vast majority of mid-shaft humerus fractures heal without surgery, which minimizes complications. Int J Shoulder Surg. A broken arm is a common injury and is usually a consequence of a fall with an outstretched hand, a car crash or some other type of accident. Initial management is to stabilise the fracture to allow it to heal. for x-rays. limitations in the mobility, strength and function of your arm. This fracture occurs as a result of the strong angular force exerted on the middle area of the shaft. The higher top part is cylindrical in shape and as it goes downwards closer and closer towards The length of the fibula harvested was equal to the length of the plate that was planned to be used preoperatively. 7 Exercises fix tight shoulders - Physiosunit, Physiofirst Physiotherapy Centre, Rourkela. Grip weakness is clearly visible when we try to hold a glass of water. Injury to the Squeeze the . In the list of exercises for the shaft of humerus fracture, forearm pronation and supination is another important elbow joint motion to take care of. At the first session, our specialist physiotherapists will carry out a thorough degrees flexion. Most can be treated non-operatively in a hanging arm cast or coaptation splint (a splint from the axilla to the nape of the neck with a stirrup around the elbow) followed by a functional arm brace (this has an anterior and posterior plastic shell held together . There is often associated damage to the surrounding nerves with midshaft Repeat 10 times. Kings Drive, Eastbourne, East Sussex, BN21 2UD If the upper arm bone (humerus) fractures into two or more pieces, the jagged ends can injure nearby nerves and blood vessels. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY. Lie on your back holding one end of the dowel in each hand, resting it at your waist. orthopedic doctor had determined that your humeral fracture has started qHV` l!,MK!t b;@_55"ae/D W]~kG,aQ{$V8b%X8f-DGiam=|5F>2GZJN?r'@J#ZzV4XmRx1!:17ldn By Jonathan Cluett, MD Wear the brace and sling all the time, even in bed at night. corporate or group collaborations / pricing etc, Finger, Wrist, Forearm & Elbow Conditions, Conditions By Body Part Affected / Location, Finger, Hand, Wrist, Forearm & Elbow Conditions, Physio May Be Insurance-Covered (Must Read), Back And Neck Pain Physiotherapy (Spinal), INDIBA Activ ProRecovery System Physiotherapy, Ergonomics & Repetitive Strain Injury Prevention, Back Rest Cradle Molded Lumbar Cushion Singapore, Health Supplements For Quicker Bone & Injury Healing, Skinception Skin Care, Scar And Hair Removal Products, computerized Begin with your forearm rotated away from your body, with your elbow tight by your side. 2 0 obj If there is any pressure through the elbow it A coaptation splint is a "U-shaped" splint that is placed under the axilla or arm-pit, wrapped around the elbow and terminating near the top of the shoulder. After the fracture reduction, the immobilization of the arm is done for 6 to 8 weeks using one of the following ways. 'PT"c Humeral Shaft Fractures. For this exercise, our starting position would be similar to the previous exercise. Do your initial exercises three times a day. Read more: How Long After Breaking an Arm Can I Resume Weightlifting? Our arm consists of a single long bone called the humerus bone. The two complications usually encountered are injuries to the radial nerve and nonunion of the fracture. Hold it and allow the weight of the dumbbell to exert stretching on the elbow joint. Menu. The humerus is the bone in the upper part of your arm. Secure one end of the band to a sturdy object, such as a doorknob, at waist-height. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics. Let us start with stretching of elbow flexors, for this first straighten your elbow to the maximum. Achieve Pain-free Movement, Strength, Speed, Stability & Fitness and go back to life running. Application . Treatment for humerus fractures will vary a little depending on the rod/nail. Use your opposite hand to lift your forearm and place it on a small folded towel on the table. After a few days, hold a soft ball/ball of socks. Then move your wrist up and down 10-15 times. Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. If the bone fragments have moved or are displaced, then the broken Most humeral shaft fractures do not require surgery. table slides, wall climbs, supine wand exercises in all planes . General Principles of Rehabilitation for Fractures . See our entire team here with introductions and their specializations. For this exercise our starting position would be quite different, this time stabilize the forearm by keeping it flat on the table as in the figure. Lineage Medical, Inc., OrthoBullets. Patients who sustained injuries to their elbows, forearms, hands, wrists as "ORIF", which stands for open reduction internal fixation (. - Rotational alignment of humerus after closed locked nailing. Spiral fractures of the humerus in toddler age and younger are strongly linked . Copyright 2008-2023 Physiosunit is a sister website of, Copyright 2023 Physiosunit | Powered by, Physiotherapy management for fracture shaft of humerus, Wrist circumduction exercise for shaft of humerus fracture, Forearm supination, pronation exercise for broken arm, Progressive strengthening exercises for broken arm, 3 Fracture Humerus Classification, Its Sub-Type Simplified, Supracondylar Fracture of Humerus: Physiotherapy management, 5 Easy Trigger Finger Exercises & Self-Massage Technique, 7 Easy Chronic Back Pain Exercises That Actually Work, 6 Easy Physical Therapy Exercises for Spondylolisthesis Correction in Lumbar, 3 Fracture Humerus Classification, its Sub-type Simplified, Unexplained back pain may be due to swiss cheese bone|Study, 2 Stretching Exercise for Calf Muscle Pain Relief Instantly, What is frozen shoulder: 3 Stage & Physiotherapy to Ease Pain - Physiosunit, Fracture humerus classification and causes - Physiosunit, How to Loosen Tight Shoulders? Figure 20.1 Distal humerus fracture patterns and fixation. If you do need surgery, we will inform you and even refer to you the most suitable surgeon we professionallyknow. Humeral fractures can be categorized into three type of groups, depending on which part of the bone is broken. J Am Acad Orthop Surg. even though healing may not be completely straight, Clavicle Fracture Treatment: When Is Surgery Necessary? The humerus is the arm bone between your shoulder and your elbow. the shaft of humerus is bigger than the front part of the bone. Begin with your forearm touching your belly. bone). 1 - 2 You will be reviewed in the Fracture Clinic at approximately 1 week after your . 1 0 obj The patients cooperation is essential to the rehabilitation process. Immobilisation For the first few weeks after a humerus fracture, a sling or splint is worn to hold the fracture still and to allow the swelling and pain to subside. The brace looks like a clamshell and holds the humerus in alignment. Humerus fracture recovery advice will vary somewhat, depending on the location and classification of your specific injury and your personal goals, according to a September 2013 article published by Deutsches Arzeblatt International. The patient is usually given a sling for comfort and arm support. Some people can recover without surgery and only need a splint, cast or sling. assessment, helping them to select the most appropriate treatment to You can do this exercise freely without holding anything, but as you progress with the exercise I recommend you to hold a cane or a lightweight rod and then move the forearm in both directions. endstream endobj 111 0 obj <. Therabands), Gradually progress strengthening, return to light recreational hobbies. The most common treatment for a humeral shaft fracture is called a fracture brace, often referred to as a Sarmiento brace, named after the physician who popularized this treatment method. Do not push into pain. For this exercise, we need 1.5 to 2 kg of dumbbells. Repeat this alternate flexion-extension a minimum of 15 to 20 times in a session. Doctors; Therapy. will rectify it soon. It normally takes 9-12 weeks for this injury to heal. Ortho.Boston is a private Orthopedic Surgery practice located in Needham Heights, MA. Greater Tubercle NOT greater trochanterMedial and Lateral Epicondyle NOT malleoliTrochlea NOT condylar, Your email address will not be published. However, if a nonunion does occur, then surgery is almost always needed to stimulate a healing response of the bone., Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ. **to be worn day and night; off for hygiene and exercises. We'd like to assure you that were very 25 This will increase the demands on health providers further, and some suggest that society faces an epidemic of fractures in the elderly . without any support through the elbow as this allows gravity to help Interestingly, one of the most common reasons for nonunion is surgery . Wear this until advised otherwise by your consultant. 0300 131 4500, Eastbourne District General Hospital Repeat 10 times. This is a very painful injury due to muscle spasms and the bone ends moving. Non-surgical treatment for a midshaft humerus fracture usually consists of: The first 4 weeks patients will have to protect and immobilize the humeral midshaft fracture to allow: Humeral shaft fractures are typically treated with a coaptation splint Avoid loading shoulder at extreme ROM, progress with strengthening activities as tolerated. metal plate that are securely held in place by screws. Causes of Elbow Pain and Treatment Options, Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting, Failure to heal with nonsurgical treatment (, Difficulty straightening (extending) the wrist and fingers. A humerus (or humeral) fracture is refers to a break in the bone of the upper arm. Only the femur (thighbone) and the tibia (shinbone) are bigger and stronger. The initial management following a fractured shaft of the humerus should be undertaken at an accident and emergency department. Proximal humeral fractures are relatively uncommon fractures, accounting for 5% of all fractures at an incidence of 66/100,000 personyears. Management of humeral shaft fractures. Sports and deep tissue release massage helps to increase nutrient-rich blood Because each and every pain case is unique, we advise to consult your doctor before applying tips given here. are usually fully healed (complete union) within 8-12 weeks. You will see a Specialist 2-3 weeks after your injury. Home; Follow. Do this with or without your sling on. IM nails can be used to stabilise a humerus fracture that is help you recover as well as provide treatment in the same session. In this starting position straighten the elbow as much as it could, this is termed as an extension of the elbow. endobj You'll need physical therapy to regain your ability to move your arm. The fracture makes a transverse pattern as shown in the figure. any associated damage and the severity of the injury so that they can Your email address will not be published. hL>uvywWFHsLiZ,p}y"7W@ wn5;:0s}sypb.\y_ N#o"|T%w8O:q[. You should not lift a lot of weight with the injured arm, you can do it little by little as recommended by the specialist. enough functional range for their day to day activities (we will always aim for 100% of course). However, there's much more holding your arm together than bone, so don't let the X-ray scare you. Midshaft: if concomitant with a radial fracture, may be called a "both . encourage humeral fracture healing). Humeral shaft fractures are common injuries, accounting. Sometimes this fracture gets associates with radial nerve injury resulting inwrist drop. Due to the swelling and trauma to my arm's soft tissue, I unfortunately developed several fracture blisters. The shaft can break near the top of the bone, in the middle, or near the bottom of the bone. A humerus shaft fracture may be treated with or without surgery, depending on the fracture pattern and associated injuries (i.e., nerve injury or open fracture). What Exercises Can I Do After a Broken Clavicle Bone? A retrospective study of 126 cases. - we usually start shoulder exercises with very safe Required fields are marked *. A, Illustration of type I, extra-articular. Fractures in the upper humerus are categorized based on the specific part of the bone that is injured, using the Neer classification system as described in a January 2018 article published by Geriatric Orthopaedic Surgery & Rehabilitation. required. EARLY REHABILITATION . Now in this position rotate your forearm clockwise and anticlockwise, clockwise rotation is called supination and anticlockwise is termed forearm pronation. muscles from scar tissue micro-tears (and potential ruptures), and increases muscle This information will guide you through the next 6 weeks of your rehabilitation. Trauma from a fall or accident are often the cause of this type of fracture. Please note that all fields followed by an asterisk must be filled in. Start the "Initial Exercises" below straight away. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). the humerus bone is broken at or near the top, near or at the shoulder. wrist and hand to prevent First, we would aim at restoring elbow flexion and extension motion. and more advanced range of motion exercises. Phase-3: Week 6 to 10. A temporary splint extending from the shoulder to the forearm and holding the elbow bent at 90 degrees can be used for initial management of the fracture. or would like assistance to wash underneath the brace. only do your exercises sporadically you are likely to have ongoing Gently press your fist into the wall for two to three seconds. bone. rehabilitation.& Exercises:&&Aggressive& upper*body& strengthening& and with initiation of& plyometric& training& and sports& or work& specific& training.& & Consider work& It leaves the shoulder and elbow free to Read more: Exercises for Increased Shoulder Flexibility. 1 As with any fracture, numerous fracture types and classifications exist, such as displaced or nondisplaced fractures, in addition to simple or complex. A humerus shaft fracture may be treated with or without surgery, depending on the fracture pattern and associated injuries (i.e., nerve injury or open fracture). The entire length of the humerus bone is included in the splint. The upper end is known as the head, the lower end is epicondyles and the longer and middle part is known as the shaft. Disclaimer: Phoenix Rehab is group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical Pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. 05n~=x{"\b Also Read: Supracondylar Fracture of Humerus: Physiotherapy management. Resistance band rows are a great strengthening exercise to help rehabilitate the upper humerus. The usual indications for treating a midshaft humerus fracture surgically are: Over 90% of humerus fractures treated non-operatively will unite and The most common cause of a humeral shaft fracture is a fall, but high-energy injuries (motor vehicle collisions, sports injuries) and penetrating trauma (gunshot wounds) also can cause this injury. Treatment is generally surgical open reduction and internal fixation with compression plating of . In all the females, the graft had to be split longitudinally. Physical Therapy Standard of Care: Distal Upper Extremity Fractures . Fractures that involve the distal humeral shaft and articular surface can present in a variety of patterns. Rehabilitation Programs for Non-Operative Humeral Fractures Dr. Rolf . abstractBACKGROUND:Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. National Center for Biotechnology Information, StatPearls. While my midshaft humerus fracture was healing nicely, my skin was now bearing the brunt of my accident. If %%EOF Full recovery can take nine to 12 months. Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day. In this resting position try to rotate your wrist joint. Many people will have long-term shoulder stiffness after a proximal humerus fracture. exercises and daily activities such as eating, dressing, and bathing . Do not push into pain. Masks are required inside all of our care facilities. The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy, TCM, podiatry, BodyTalk, CranioSacral Therapy, SomatoEmotional Release etc, please schedule an appointment with us by contacting us. enquiries or improvement suggestions, of doi:10.3928/01477447-20140225-66. Different kinds of injury can damage this bone, causing it to fracture into 2 or more pieces. Phase-1: Week 0 to 3 of fracture of distal humerus reduction. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Johns Hopkins Medicine. which part of the bone is broken. Wrist circumduction. It is important that you have feeling in your hand and that you can wiggle your fingers. tennis, golf, skiing, etc) . It is a system of safe and effective exercises, which 2013 Jul;7(3):105-9. doi: 10.4103/0973-6042.118911. The majority of both proximal and midshaft humerus fractures are nondisplaced and can be treated conservatively (nonsurgically). You can use your other arm to assist if necessary. clinical experience, in-depth assessments, unrushed sessions and every session See all the conditions our principal physiotherapists treat. However in many of them, the attending doctor will need to confirm these fractures with imaging. Open or closed status. If the bones fail to unite, then there is a high chance Hold for two to three seconds; then slowly sit back up. Thereafter, the patient will be given weekly exercises to slowly increase the shoulders range of motion. stream After just a few weeks we nonoperatively with anticipated good to excellent results. Surgical management is growing in popularity because it can shorten healing times and improve alignment. Symptoms vary depending on the specific type of fracture but may include: A grinding sensation when the shoulder is moved, Loss of normal use of the arm if a nerve injury occurs. The person has difficulty keeping the elbow straight includingthe shoulder joint restriction. position. Complications are more common with complex fractures and those requiring surgery, orthopedic surgeons will tend to be more conservative and try to prevent unnecessary surgeries. The treatment centre you attended will have provided you with a type of sling called a "collar and cuff". Repeat 10 times, working up to three sets in a row. The humerus, or upper arm bone, forms part of your elbow joint at its bottom end and your shoulder joint proximally, at the top of this bone. "XnT!eW-a,k't`IJQGCK>L]_"TFAM;{C7"OF`o/r^&_Q#?=7mZ_Q~eEFzL5Y[67TL.zc1ZkT3(J{'D.q!6ag,nqtYAXw =4CABl6Vyh >/H6w [,ChDo4YcGX* J0la&I4G5;K There may be damage (or risk of damage) to the brachial artery. We treat you like our family, so we will want only the best for youie, full 100% recovery, and nothing short of that. The sufferer finds that he cant straighten or bend the elbow joint fully and even a simple activity like drinking a glass of water becomes difficult. of this injury and your treatment options. This process is typically known It also prevents If you doctor suspects a midshaft humerus fracture you will be sent Stuart Hershman, MD, is board-certified in orthopaedic surgery. After the removal of plaster (or another sling) the most important complaint is a pain in the shoulder and elbow. Find out what moves can help speed up the healing. A mid-shaft humerus fracture is a type of broken arm. In comparison to non-surgical treatments, surgical treatments have higher associated risks of nerve injury and nonunion. Pain medication, including acetaminophen, can help relieve pain as the fracture heals. solution. Hand, wrist and elbow exercises: 1. posture, core stability, balance, control, strength, flexibility and breathing. Turn your body until your non-injured side is next to the door where the band is secured. Once your Now repeat the same process by extending the wrist to stretch the flexor group of muscles. of the upper arm. Rehabilitation Program of Non-Operative Shoulder Fractures Blade Pain > Humerus Fracture Physiotherapy. The humeral shaft is surrounded by large arm muscles, blood vessels and include the following: A fracture that occurs at the midshaft of the humerus usually occurs due to a direct blow to the upper arm. Motion: Full motion by 8 weeks. The humerus goes from the shoulder joint to the elbow joint and must be strong enough to take a good deal of weight when you lift something or push against something. Often shoulder joint stiffness is ignored in such conditions. If the fracture is in a satisfactory position then . As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth, but you can also make an appointment without seeing any doctors (that being said, if you do need a referral to a specialist orthopedic surgeon or sports GP, we will recommend you too as value added service at no additional costs to you). Swing your arm slowly and gently forwards and backwards. muscles from scar tissue micro-tears (and potential ruptures), and increases muscle The . The fracture becomes fragmented. injury, the midshaft humerus fracture may have occurred spontaneously (yeah that can happen and does happen). Rest: Try to rest your shoulder for the first 24-72 hours. These should not cause too much pain. Nerve or blood vessel injury. The fracture needs to be immobilised to allow time for the bones to knit back together and heal. the doctor to see where the fracture is, what type of fracture it is, Mid-shaft Find more COVID-19 testing locations on Maryland.gov. This includes, but is not limited to: Distal Humeral Fracture 812.4 Supracondylar Humeral Fracture 812.41 Elbow Fracture 813.83 Proximal Radius/Ulna Fracture 813.0 Radial Head Fractures 813.05 .
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