Shoulder

Proximal Humerus Fractures

What is a proximal humerus fracture?

Proximal humerus fracture is a very common osteoporotic fracture in older individuals. Poor bone quality can contribute to this type of fracture. This fracture involves the ‘ball” of the ball and socket shoulder joint.

 

What causes a proximal humerus fracture?

Low energy falls combined with weaker bone quality are the typical cause of proximal humerus fractures. However, they can occur in younger individuals with higher energy trauma, such as a motor vehicle accident.

 

How is a proximal humerus fracture diagnosed?

Proximal humerus fracture is typically diagnosed with x-ray. Occasionally CT scan may be required to provide additional information.

 

How is a proximal humerus fracture treated?

80% of proximal humerus fractures can be treated without surgery. Treatment with a sling initially followed by gentle and progressive physical therapy can result in good function. This treatment is most often recommended for older/ elderly individuals and those with minimally or non-displaced fractures.

 

When is surgery is necessary?

Surgery can be necessary for fractures that are significantly displaced, head splitting fractures of the smooth shiny white surface of the ball, fracture dislocations, and for fractures that have healed improperly (malunions or nonunions). Proximal humerus fractures can be treated with fixation (plates, screws, cage) or with shoulder replacement (reverse, hemiarthroplasty).