Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
A proximalhumeralfracture is a broken bone that occurs near your shoulder joint. “Proximal” refers to being close to your body, and “humeral” refers to the arm bone known as the humerus.
A proximal humeral fracture can be a painful injury that limits your ability to move your arm and shoulder. This can have a significant impact on your ability to work, perform household duties, or enjoy recreational activities.
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Proximal humeral fractures can be treated conservatively with an arm sling, pain management, and supportive care. While surgery is rarely necessary, some severe fractures, including badly displaced fractures oropen fracturesmay require a surgical procedure.
A physical therapy program after a proximal humeral fracture can help you return to normal activity quickly and safely.
A fracture of yourproximal humerususually involves significant trauma to your arm or shoulder. The elderly are vulnerable to these fractures due to an increased risk of osteopenia (bone loss). Proximal humeral fractures are typically the result of:
If you suspect that you have a proximal humeral fracture, it is important to see your healthcare provider or emergency room as soon as possible. Failure to do so may result in the significant (and possibly permanent) loss of arm function.
Chief among the concerns isavascular necrosis (AVN)in which the localized loss of blood flow results in bone death.
If your healthcare provider suspects that you have a fracture, an X-ray will likely be taken to confirm the diagnosis. Occasionally, more advanced pictures of your shoulder will be taken with a computed tomography (CT) scan. These images help your practitioner see the severity of your injury and help decide on the best way to manage your injury.
If a proximal humeral fracture is confirmed, the fracture may need to be reduced. Most often, the fractured pieces of bone are close together will not require much to reduce the fracture.
For severe fractures where the bone pieces are far apart, a surgical procedure called anopen reduction internal fixation (ORIF)or a shoulder replacement including a hemiarthroplasty or reverse shoulder replacement may need to be performed. Your healthcare provider will discuss with you the options and best treatment strategy for your specific condition.
According to a 2019 study in theJournal of Orthopaedic Surgery and Research,the vast majority of proximal humeral fractures (85.4%) are treated conservatively.Indications for surgery include open fractures,pathologic fractures, or injury to major nerves or blood vessels.
There is currently no clear evidence that surgery improves outcomes in people with uncomplicated proximal humeral fractures compared to conservative therapies.
Physical Therapy
Your first encounter with a physical therapist may take place immediately after injury in the hospital. The physical therapy may start with a lesson onhow to properly wear your sling.
You may also be taught gentle pendulum exercises to help keep your shoulder mobile as it heals. Your healthcare provider will let you know if it is safe to perform these exercises.
In four to six weeks, you may be ready to partake in active physical therapy. After a thorough evaluation, your physical therapist will provide you an outline of exercises and treatments to aid in your recovery. This will typically focus on five things:
Eight to 12 weeks after the injury, your strength and mobility should have improved enough to return to full activity. Your pain level should be minimal as well.
If you underwent an ORIF procedure, you can expect to be fully restored to work in an average of 48 days if you are an office worker and 118 days if you are a physical laborer, according to a 2014 study inOpen Orthopaedics Journal.
A Word From Verywell
If you have suffered a fracture of your proximal humerus, you may benefit from the skilled services of a PT to help you fully recover. By understanding what to expect during rehab, you can have all the necessary information to participate fully in your humerus fracture rehab and ensure you have the best possible recovery.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rudran B, Little C, Duff A, Poon H, Tang Q.Proximal humerus fractures: anatomy, diagnosis and management.Br J Hosp Med. 2022;83(7):1-10. doi:10.12968/hmed.2021.0554Floyd SB, Campbell J, Chapman CG, et al.Geographic variation in the treatment of proximal humerus fracture: an update on surgery rates and treatment consensus.J Orthop Surg Res.2019;14:22. doi:10.1186/s13018-018-1052-2Handoll HH, Brorson S.Interventions for treating proximal humeral fractures in adults.Cochrane Database System Rev. 2015;11(11);(11):CD000434. doi:10.1002/14651858.cd000434.pub4Dietrich M, Wasmer M, Platz A, Spross C.Return-to-work following open reduction and internal fixation of proximal humerus fractures.Open Orthop J. 2014;8:281-7. doi:10.2174/1874325001408010281
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rudran B, Little C, Duff A, Poon H, Tang Q.Proximal humerus fractures: anatomy, diagnosis and management.Br J Hosp Med. 2022;83(7):1-10. doi:10.12968/hmed.2021.0554Floyd SB, Campbell J, Chapman CG, et al.Geographic variation in the treatment of proximal humerus fracture: an update on surgery rates and treatment consensus.J Orthop Surg Res.2019;14:22. doi:10.1186/s13018-018-1052-2Handoll HH, Brorson S.Interventions for treating proximal humeral fractures in adults.Cochrane Database System Rev. 2015;11(11);(11):CD000434. doi:10.1002/14651858.cd000434.pub4Dietrich M, Wasmer M, Platz A, Spross C.Return-to-work following open reduction and internal fixation of proximal humerus fractures.Open Orthop J. 2014;8:281-7. doi:10.2174/1874325001408010281
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Rudran B, Little C, Duff A, Poon H, Tang Q.Proximal humerus fractures: anatomy, diagnosis and management.Br J Hosp Med. 2022;83(7):1-10. doi:10.12968/hmed.2021.0554Floyd SB, Campbell J, Chapman CG, et al.Geographic variation in the treatment of proximal humerus fracture: an update on surgery rates and treatment consensus.J Orthop Surg Res.2019;14:22. doi:10.1186/s13018-018-1052-2Handoll HH, Brorson S.Interventions for treating proximal humeral fractures in adults.Cochrane Database System Rev. 2015;11(11);(11):CD000434. doi:10.1002/14651858.cd000434.pub4Dietrich M, Wasmer M, Platz A, Spross C.Return-to-work following open reduction and internal fixation of proximal humerus fractures.Open Orthop J. 2014;8:281-7. doi:10.2174/1874325001408010281
Rudran B, Little C, Duff A, Poon H, Tang Q.Proximal humerus fractures: anatomy, diagnosis and management.Br J Hosp Med. 2022;83(7):1-10. doi:10.12968/hmed.2021.0554
Floyd SB, Campbell J, Chapman CG, et al.Geographic variation in the treatment of proximal humerus fracture: an update on surgery rates and treatment consensus.J Orthop Surg Res.2019;14:22. doi:10.1186/s13018-018-1052-2
Handoll HH, Brorson S.Interventions for treating proximal humeral fractures in adults.Cochrane Database System Rev. 2015;11(11);(11):CD000434. doi:10.1002/14651858.cd000434.pub4
Dietrich M, Wasmer M, Platz A, Spross C.Return-to-work following open reduction and internal fixation of proximal humerus fractures.Open Orthop J. 2014;8:281-7. doi:10.2174/1874325001408010281
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