PROXIMAL HUMERUS FRACTURE                              KANDILNOTES                                                                               

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

proximal humerus fracture capture 1.png