Fractures around the shoulder come in many varieties, including clavicle fractures, proximal humerus fractures, and fractures of the scapula and glenoid. This page discusses fractures of the proximal humerus.
Fractures of the proximal humerus are classified according to the number of pieces into which the bone breaks, the location of the break, the amount of displacement of the fragments, and the patient’s level of activity and age at time of fracture. Proper treatment of these fracture is essential to avoid unneeded surgery as well as to restore maximum function after and injury.
Examples of proximal humerus fractures
Shown in the figures to the right are A) normal xray, B) a two part, non-displaced fracture of the proximal humerus, and C) a four part fracture that involves the joint surface.
How are proximal humerus fractures treated?
Treatment of these fractures varies according to the type of fracture and the medical status of the patient. Typically, simple fractures where the fragments have not moved much can be treated with a sling for rest followed by physical therapy to restore motion and strength. Excellent outcomes can be achieved through this method of treatment.
More complex fractures such as the one shown in Figure C can benefit from surgical treatment. Benefits of surgery can include increased motion and strength as well as reduced pain and risk of future arthritis. The types of surgeries vary according to the the pattern of the fracture. One treatment option is to repair the bones and tendons to their preinury shape and fix these structures with a metal plate and scrows (open reduction internal fixation or ORIF) This is shown in Figure D. Other treatment options include joint replacement surgery (Figure E) for fractures too severe or too fragile to be repaired.
How do I know which treatment option is best for me?
Proximal humerus fractures can be simple or highly complex to treat. Significant experience is necessary to assist patients with choosing the optimal treatment plan. Dr. Rose has experience with all of the above techniques and can provide an assessment and explanation of the options available to you. Please contact us to schedule an appointment.