INTRODUCTION​

• Shoulder bone (proximal humerus) fractures are common injuries to the upper extremity

• Many different types of fractures exist, characterized by location, age (pediatric vs. adult), and amount of angulation or displacement

• 5% of all fractures are proximal humerus fractures

• Common in patients of all ages

• 2x more common in females 

CAUSES

• Proximal humerus fractures occur when a person falls on their shoulder

Risk factors include osteoporosis, obesity, diabetes, female gender 

SIGNS AND SYMPTOMS

• Pain and swelling over the shoulder

• Tenderness over the shoulder 

• Prominence or deformity of the shoulder

• Bruising over the shoulder

TREATMENT​​

• Most proximal humerus fractures are treated without surgery

• Factors associated with nonsurgical treatment include: younger age, minimal displacement, minimal angulation

• Factors that increase the risk of surgery include: older age, greater displacement, and angulation. These risk factors increase the risk of the fracture ends not healing, leading to a nonunion and persistent pain

• Patients treated non-operatively usually are placed in a sling for a few weeks followed by a course of physical therapy or a home exercise program 

• In patients where surgery is indicated, the procedure is a proximal humerus repair with a plate and screws. The procedure is very common and has high success rates

• In complex proximal humerus fractures, a reverse shoulder replacement may be indicated if the prognosis for healing is poor

PREVENTION​

• Improve bone density through proper nutrition and avoid activities that put you at risk of falling on your shoulder