Proximal Humerus Fracture
synonyms: proximal humerus fracture,
Proximal humerus fractures are common injuries, escpecially in the elderly population. They often occur from simple falls. These fractures occur more often in women than men. The majority are minimally displaced and do not required surgery. 15-20% of proximal humerus fractures are severe enough that they may require surgery to achieve the best outcome.
People with proximal humerus fractures generally complain of shoulder pain after a fall. They often have swelling and bruising in the shoulder which can extend into the chest wall and down the arm. These injuries are often associated with nerve lesions in the arm.
Treatment depends on how severe the fracture is and if there any other associated injuries. Treatment options include non operative treatment, closed reduction and percutaneous pinning, open reduction and internal fixation, shoulder hemiarthroplasty and reverse total shoulder arthroplasty. You should discuss your fracture and the various treatment options with your orthopaedic surgeon. Regardless of treatment method these fractures are typically slow to heal and associated with significant stiffness in the shoulder which frequently requires physical therapy.
The risks of surgery include but are not limited to: Nonunion, Malunion, avascular necrosis of the humeral head, Persistent weakness, hardware failure, Shoulder stiffness, incomplete relief of pain, incomplete return of function or motion, incomplete return to sport, need for further surgery, infections, Heterotopic ossification, reactive bursitis, CRPS, nerve or vascular injury, hematoma, DVT/PE, and the risk of anesthesia including heart attack, stroke and death. Complications are uncommon and the most patients are satisfied with the results of surgery.
Following surgery people generally are placed into a shoulder immobilizer for 4-6 weeks. Patients begin Elbow/wrist/hand range of motion exercises immediately. They follow-up with there surgeon 10-14 days after surgery. The post operative course and physical therapy is dependent on type of fracture and surgical treatment. Your orthopaedic surgeon will discuss this with you after surgery. Recovery of motion is the greatest difficulty, especially after surgery and severe fractures.
Every person and their particular circumstances are different so the treatment for your shoulder may be different than those discussed. Please read this information carefully. Write down any questions that you have about your shoulder and its treatment and discuss them with your orthopaedic surgeon. Working together you and your orthopaedic surgeon will determine the best treatment for you.
Appointments to discuss proximal humerus fractures with Dr. Grutter can be made here. If you have continued questions or concerns after seeing your orthopaedic surgeon a second opinion from Dr. Grutter is often beneficial.