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Proximal Humerus

The proximal humerus is subject to fracturing. The humerus is a long, slender bone running from the elbow to the scapula. Humeral fractures are quite common and can be classified into proximal humerus and humerus shaft fractures. A proximal humerus fracture is in close proximity to the shoulder joint but can indicate two fracture patterns: simple and comminuted. The arm is commonly susceptible to fracturing, particularly at the central portion of the bone that usually occurs when landing on outstretched hands or as a result of an injury or car crash.

Trauma to the proximal humerus is relatively common and generally results in a fractured humerus. The injury occurs when the shoulder joint's ball is broken and occurs at the top of the humerus bone. In many cases, surgery is not required as the fractures tend to be non-displaced, and a supportive sling may be sufficient in allowing the bone and soft tissue to heal.

Non-operative treatments for proximal humerus fractures include using a shoulder immobiliser (sling) for at least 6-weeks to repair the fracture. Typically, surgery is not required when pieces of the proximal humerus have not shifted excessively. Other factors are said to be considered before considering non-operative treatments over surgical fixation. Let us consider bone fragments shifting extensively out of place, and then we have no option but to carry out a surgical repair.

In cases where the fractures are displaced, humerus fracture surgery is required. If surgery is recommended, I will perform the procedure in order to realign the bone or pieces of bones that have been displaced. A realignment may involve metal implants such as a plate and screws, while a complete shoulder replacement may be performed in very severe cases. The fracture pattern and the number of parts broken will determine if a replacement is necessary.

FAQ

  • Pain in the area (typically the arm)
  • Swelling around the shoulder
  • An uncomfortable grinding feeling when rotating the shoulder
  • A deformed arm/shoulder

Yes, both mid-shaft and proximal humerus fractures heal without surgery. Methods of immobilisation include using a sling, splint or brace to keep your arm from getting hurt even more.

Humerus fractures are a severe form of injury. Most patients are requested to take pain medications to alleviate discomfort from a fracture. The broken bone may become painful, inflamed and stiff.

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