Proximal humerus fracture

What is a proximal humerus fracture?

The shoulder joint is comprised largely of the humerus (the ball) and the glenoid (socket). A proximal humerus fracture is a break at the top part of the humerus near the shoulder joint. Proximal humerus fractures are most common in patients older than 65 with osteoporotic bone. They typically occur as a result of a ground-level fall.

Deformity at the fracture site is determined by the severity of the fracture and the pull of the muscles on the fracture fragments.

What causes a proximal humerus fracture?

Most proximal humerus fractures are the result of a ground level fall. Proximal humerus fractures in younger patients are typically the result of a more high-energy injury, such as a motor vehicle or bicycling accident.

What are the symptoms of a proximal humerus fracture?

Proximal humerus fractures cause significant pain, swelling, and bruising along the length of the arm. Pain worsens with any motion through the shoulder.

How is a proximal humerus diagnosed?

A proximal humerus fracture is diagnosed based on a combination of history, physical exam, and standard X-rays. In some cases, a CT scan is required to better understand the fracture pattern.

How is a proximal humerus treated?

Most proximal humerus fractures can be treated without surgery. This involves a period of immobilization in a sling, pain control measures, and ultimately physical therapy to optimize strength and range of motion. Some fractures, however, are best treated with surgery. Fracture patterns with significant displacement are often more predictably treated with surgery. Surgical options typically include restoring normal anatomy with a plate and screws versus a reverse shoulder replacement. This decision is influenced by the patient’s age and demands in addition to the severity of the fracture.