success error

Form Is Invalid!

logo

Jennifer Lucas - Jun 10, 2023 - 7 min read - 1k Likes

Proximal Humerus Fracture: Causes, Symptoms, and Treatment

Welcome to our comprehensive guide on proximal humerus fractures. In this article, we will explore everything you need to know about this type of injury, including its causes, symptoms, and treatment options. Whether you or a loved one is currently dealing with a proximal humerus fracture, or you simply want to learn more about this injury, this guide is for you. By the end of this article, you will have a better understanding of what a proximal humerus fracture is, how it can be treated, and what to expect during the recovery process. So, let’s get started!

Causes of Proximal Humerus Fracture

A proximal humerus fracture can occur due to various factors, ranging from traumatic injuries to underlying medical conditions. Understanding the causes of this type of fracture can help in preventing it and seeking timely medical attention.

Some common causes of proximal humerus fractures include:

  • Trauma: A fall, direct blow, or impact to the shoulder region can cause a proximal humerus fracture. This type of fracture is commonly seen in athletes who engage in contact sports or older adults who are at risk of falls.
  • Osteoporosis: Weak and brittle bones due to osteoporosis can increase the risk of fractures, including proximal humerus fractures. This condition is more common in older women.
  • Repetitive stress injuries: Repetitive overhead activities, such as throwing a ball or lifting weights, can cause stress fractures in the proximal humerus. This type of fracture is commonly seen in athletes, especially baseball pitchers.

While these are the most common causes of proximal humerus fractures, underlying medical conditions such as cancer, infections, or metabolic disorders can also increase the risk.

It’s important to seek medical attention if you experience any symptoms of a proximal humerus fracture, especially if you are at risk due to age or lifestyle factors.

Symptoms of Proximal Humerus Fracture

A proximal humerus fracture can cause a wide range of symptoms, depending on the severity of the injury. Some patients may experience mild pain and limited mobility, while others may have more severe symptoms that require immediate medical attention. Here are some of the most common symptoms of a proximal humerus fracture:

  • Pain: The most common symptom of a proximal humerus fracture is pain. Patients often report sharp, intense pain in the affected shoulder, which may be worse when moving the arm or lying on the affected side.
  • Swelling: Swelling and bruising around the shoulder joint are also common symptoms of a proximal humerus fracture. The area may feel tender to the touch and may appear visibly swollen or discolored.
  • Stiffness: Patients may experience stiffness and limited mobility in the affected shoulder, making it difficult to perform everyday tasks like reaching or lifting objects.
  • Weakness: Proximal humerus fractures can also cause weakness in the affected arm, making it difficult to perform routine activities like brushing hair or lifting groceries.
  • Popping or clicking sounds: In some cases, patients may hear popping or clicking sounds in the affected shoulder when moving the arm.

If you are experiencing any of these symptoms, it is important to seek medical attention right away. A healthcare provider can perform a physical exam and order imaging tests to determine the extent of the injury and recommend the appropriate treatment.

Diagnosis of Proximal Humerus Fracture

If you suspect that you have a proximal humerus fracture, it is important to seek medical attention as soon as possible. A doctor will be able to assess the severity of the fracture and recommend appropriate treatment options.

The diagnostic process for a proximal humerus fracture will typically involve a physical examination, including a visual inspection of the affected area and tests to assess your range of motion and muscle strength. In addition, your doctor may order imaging tests, such as an X-ray, MRI, or CT scan, to get a more detailed view of the fracture.

 Diagnostic tools Notes
X-ray This is often the first imaging test performed to diagnose a proximal humerus fracture.
MRI This test is used to evaluate the extent of soft tissue damage and nerve injury following a fracture.
CT scan This imaging test is used in cases where the X-ray results are inconclusive or when a more detailed view of the fracture is needed.

Once your doctor has determined the severity of your proximal humerus fracture, they will then be able to recommend appropriate treatment options, which may include non-surgical or surgical interventions.

Non-Surgical Treatment Options for Proximal Humerus Fracture

If your doctor determines that surgery is not necessary for your proximal humerus fracture, there are non-surgical treatment options available that can help you heal and regain mobility. These treatment options may include:

  • Immobilization: Your doctor may prescribe a sling or brace to immobilize the affected arm. This can help prevent further injury and promote healing.
  • Physical therapy: A physical therapist can design an exercise program to help you regain strength and mobility. This may include range-of-motion exercises, stretching, and strength training.
  • Rehabilitation exercises: Your doctor or physical therapist may recommend specific rehabilitation exercises, such as shoulder circles or elbow flexion, to help you regain strength and mobility.

It is important to follow your doctor’s instructions closely and attend all physical therapy and rehabilitation sessions to ensure the best possible outcome.

If you are experiencing pain or limited mobility due to a proximal humerus fracture, speak with your doctor about the non-surgical treatment options that may be right for you.

Surgical Treatment Options for Proximal Humerus Fracture

If non-surgical treatment options are not sufficient, surgical options may be necessary to repair a proximal humerus fracture. The decision to undergo surgery will depend on factors such as the severity and location of the fracture, the patient’s age and overall health, and their level of activity.

Open Reduction and Internal Fixation (ORIF)

ORIF is a surgical procedure that involves realigning the fractured bone and stabilizing it with screws, plates, or other hardware. This procedure is often used for more complex fractures or fractures that involve displacement of the bone. A surgical incision is made at the site of the fracture, and the bone fragments are repositioned before being secured with the hardware.

Shoulder Replacement Surgery

In cases where the proximal humerus fracture is severe, shoulder replacement surgery may be necessary. This involves removing the damaged part of the shoulder joint and replacing it with an artificial joint. Shoulder replacement surgery is typically reserved for cases where the bone is severely damaged or when the patient is experiencing significant pain and loss of function.

Other Surgical Procedures

In some cases, other surgical procedures may be necessary to repair a proximal humerus fracture. This may include bone grafting to promote bone healing or nerve decompression to relieve pressure on nerves that may have been damaged by the fracture. Your doctor will determine the most appropriate surgical option based on the specific circumstances of your fracture.

It’s important to note that all surgical procedures carry some risks, including infection, bleeding, and adverse reactions to anesthesia. Your doctor will discuss the potential risks and benefits of surgery with you before making a recommendation.

Recovery from Proximal Humerus Fracture

The recovery process for a proximal humerus fracture can vary depending on the severity of the injury and the treatment plan. In general, the recovery process takes several months, and it’s important to follow your doctor’s instructions to ensure the best possible outcome.

Initially, the focus will be on pain management and immobilization to allow the fracture to heal. This may involve wearing a sling or other immobilization device for several weeks. During this time, it’s important to avoid using the injured arm as much as possible to help the bone heal properly.

After the initial healing phase, your doctor may recommend physical therapy or rehabilitation exercises to help improve range of motion, decrease pain, and rebuild strength in the affected arm. These exercises may include stretching, resistance training, and functional activities to help you regain your normal daily activities.

It’s important to attend all follow-up appointments with your doctor to monitor your progress and make adjustments to your treatment plan as needed. In some cases, additional imaging tests may be ordered to ensure that the fracture is healing properly and that there are no unexpected complications.

With proper care and adherence to your treatment plan, most people are able to make a full recovery from a proximal humerus fracture and return to their normal daily activities.

Rehabilitation Exercises for Proximal Humerus Fracture

Rehabilitation exercises are an essential part of the recovery process for a proximal humerus fracture. These exercises include range-of-motion, strength-building, and flexibility exercises that aim to increase range of motion, build strength, and reduce pain. It is important to work with a physical therapist or healthcare provider to develop a rehabilitation plan that is tailored to your specific needs and goals.

Range-of-Motion Exercises

Range-of-motion exercises are designed to improve joint mobility and flexibility. These exercises may include:

Exercise Description
Pendulum exercise Lean forward with one hand resting on a table or chair. Allow your affected arm to hang straight down, then gently swing it back and forth, side to side, and in a circular motion.
Arm slide Stand facing a wall with your affected arm extended at shoulder height, palm facing the wall. Slowly slide your arm up the wall as far as possible, then back down.


Strength-Building Exercises

Strength-building exercises are designed to improve muscle strength and endurance. These exercises may include:

  • Shoulder press
  • Bicep curls
  • Tricep extensions

It is important to start with light weights and gradually increase the weight as your strength improves. If you experience any pain or discomfort, stop the exercise immediately and consult with your healthcare provider.

Flexibility Exercises

Flexibility exercises are designed to improve flexibility and reduce stiffness. These exercises may include:

  1. Doorway stretch
  2. Crossover arm stretch
  3. Wall angels

It is important to perform these exercises gently and slowly to avoid further injury. If you experience any pain or discomfort, stop the exercise immediately and consult with your healthcare provider.

Remember, rehabilitation exercises should always be performed under the guidance of a physical therapist or healthcare provider. They can help you develop a rehabilitation plan that is tailored to your specific needs and goals, and monitor your progress to ensure a safe and effective recovery.

Classifying Proximal Humerus Fractures

Proximal humerus fractures can be classified based on their severity and complexity. The most commonly used classification system is the Neer classification, which categorizes fractures based on the number of fracture fragments and the degree of displacement.

Neer Classification Description
2-part fracture The fractured bone is broken into two pieces.
3-part fracture The fractured bone is broken into three pieces.
4-part fracture The fractured bone is broken into four pieces.
Displaced fracture The fractured bone is separated and does not line up with the rest of the bone.
Non-displaced fracture The fractured bone is broken but remains in its normal position.
Comminuted fracture The fractured bone is broken into multiple pieces.

Other classification systems exist, including the AO classification system, which categorizes fractures based on their location and pattern.

The classification of a proximal humerus fracture can help guide treatment decisions and predict the likely outcome of the fracture.

Complications of Proximal Humerus Fracture

While most proximal humerus fractures can be successfully treated, there are potential complications that can arise from this type of injury. These complications can range from mild to severe and may require additional treatment and management.

Complications of Non-Surgical Treatment

If a proximal humerus fracture is being treated without surgery, there are still some potential complications to be aware of. Immobilization, which is often used to treat these fractures, can lead to muscle atrophy, joint stiffness, and decreased range of motion. Physical therapy and rehabilitation exercises can help minimize these effects and improve function.

Complications of Surgical Treatment

If surgery is required to treat a proximal humerus fracture, there are additional risks and potential complications. Infection is a risk with any surgical procedure and can require additional treatment and antibiotics. Other possible complications include nerve damage, blood vessel damage, and implant failure.

Delayed Union and Nonunion

One potential complication of any type of fracture is delayed union or nonunion. Delayed union occurs when the fracture takes longer than expected to heal, while nonunion occurs when the fracture does not heal at all. This can happen if the bone is not immobilized properly, if there is poor blood supply to the area, or if the fracture is too severe for the body to heal on its own. Treatment for delayed union or nonunion may include additional immobilization, electrical stimulation, or surgery.

Shoulder Stiffness

Shoulder stiffness is a common complication following a proximal humerus fracture, particularly if the fracture has been treated non-surgically. This stiffness can make it difficult to perform daily activities and may require additional physical therapy to improve. In some cases, surgery may be necessary to restore function.

It’s important to keep in mind that while complications can occur, the majority of people who experience a proximal humerus fracture go on to make a full recovery with appropriate treatment and management.

Proximal Humerus Fracture in Older Adults

Older adults are at an increased risk for proximal humerus fractures due to age-related changes in bone density. Osteoporosis, a condition that weakens bones, is a common cause of fractures in this population.

When treating proximal humerus fractures in older adults, doctors must consider the individual’s overall health and functional status. Non-surgical treatment options such as immobilization and physical therapy may be recommended for those who are not good candidates for surgery.

Special Considerations Treatment Options
Presence of Osteoporosis Medications to build bone density may be prescribed to prevent future fractures.
Frailty or Limited Mobility Non-surgical options such as immobilization and rehabilitation exercises may be recommended.
Underlying Medical Conditions Treatment may need to be tailored to address any underlying health issues.

Rehabilitation exercises may be particularly important for older adults recovering from a proximal humerus fracture. These exercises can help improve strength, flexibility, and range of motion, allowing older adults to maintain their independence and quality of life.

Prevention

To prevent proximal humerus fractures in older adults, it’s important to maintain good bone health through diet, exercise, and medical management of any underlying conditions such as osteoporosis. Avoiding falls and reducing the risk of trauma can also help prevent fractures.

Proximal Humerus Fracture in Athletes

Athletes who engage in contact sports or those involving repetitive overhead motions are at risk of experiencing a proximal humerus fracture. The forceful impact from a fall, collision, or tackle can cause the humerus bone to break. Additionally, repetitive stress on the shoulder joint can lead to stress fractures in the humerus bone.

Diagnosis and treatment for athletes with proximal humerus fractures can vary depending on the severity of the fracture and the athlete’s specific sport and position. In some cases, non-surgical treatment options such as immobilization and rehabilitation exercises may be sufficient for healing the fracture. However, in more severe cases, surgery may be necessary.

Rehabilitation and physical therapy are crucial for athletes with proximal humerus fractures to regain strength and mobility in the affected shoulder joint. It is important for athletes to follow a structured rehabilitation program under the supervision of a medical professional to ensure a safe and effective recovery.

Preventing Proximal Humerus Fractures in Athletes

Athletes can take steps to reduce their risk of experiencing a proximal humerus fracture. This includes incorporating exercises that strengthen the muscles and bones in the shoulder joint, maintaining proper form and technique during sports and exercises to avoid placing excessive stress on the shoulder, and wearing protective gear such as shoulder pads in contact sports.

“As an athlete, it can be frustrating to have to take time off to recover from an injury like a proximal humerus fracture. However, it’s important to prioritize your long-term health and follow a proper rehabilitation program to ensure a successful recovery.”

Frequently Asked Questions about Proximal Humerus Fracture

If you or a loved one has been diagnosed with a proximal humerus fracture, you likely have a lot of questions. Here are some of the most frequently asked questions about this type of injury:

What is a Proximal Humerus Fracture?

A proximal humerus fracture is a break in the upper part of the arm bone, near the shoulder joint. It most commonly occurs in older adults or people with osteoporosis, but can also be caused by trauma or repetitive stress injuries.

What are the Symptoms of a Proximal Humerus Fracture?

The most common symptoms of a proximal humerus fracture are pain, swelling, and limited mobility in the affected arm. Bruising or a visible deformity may also be present.

What are my Treatment Options for a Proximal Humerus Fracture?

Treatment options for a proximal humerus fracture depend on the severity of the injury. Non-surgical options include immobilization, physical therapy, and rehabilitation exercises. Surgical options include open reduction and internal fixation (ORIF), shoulder replacement surgery, and other surgical procedures. Your doctor will evaluate your specific case and recommend the best course of treatment for you.

How Long Does Recovery Take?

Recovery time varies depending on the severity of the fracture and the chosen treatment method. Some patients may need several weeks of immobilization and physical therapy, while others may require surgery and several months of recovery time. Your doctor will help you understand what to expect from your individual recovery process.

Can I Prevent a Proximal Humerus Fracture?

While proximal humerus fractures can be caused by traumatic injury, there are some steps you can take to reduce your risk. Maintaining good bone health through a healthy diet and exercise can help prevent fractures from osteoporosis. Avoiding repetitive stress injuries and using proper lifting techniques can also reduce your risk.

When Can I Return to Sports or Physical Activities?

The timeline for returning to sports or other physical activities after a proximal humerus fracture depends on the severity of the injury and your individual recovery progress. Your doctor will advise you on when it is safe to start exercising again and what types of activities are appropriate for your specific case.

You Might Also Like

author
Jennifer Lucas - Author

As an accomplished Orthopedic Surgeon, I am dedicated to the comprehensive care and treatment of musculoskeletal conditions. With a commitment to excellence, I specialize in diagnosing and managing a diverse range of orthopedic issues, including fractures, joint disorders, and sports-related injuries.

  • facebook
  • twitter
  • linkedin

Categories

Fitness starts with what you eat

Balancing regular fitness activities with a nutritious diet is the key to cultivating a healthy and vibrant lifestyle.

most popular posts

Comments

Leave a Reply

Your email address will not be published. Required fields are marked *