Proximal Humerus Fracture

 

The humerus is one of the long bones of the arm. The distal, or bottom, end contributes to the elbow joint. The proximal, or top, end contributes to the shoulder joint. During a traumatic event, like a fall, any part of the humerus is susceptible to injury. Other bones, including the clavicle (collarbone) or scapula (shoulder blade) can also be injured. However, a fracture to the proximal humerus is especially concerning due to its location and proximity to other important structures, such as the rotator cuff muscles, the brachial plexus (a web of nerves from the neck that supplies the arm), and certain tissues within the shoulder-joint capsule.

Fractures of the proximal humerus typically occur as the result of a trauma, such as a fall where the individual lands directly on the shoulder, a forceful collision, or a more complicated event, such as a car accident. Typically, the position of the arm and body at the time of the trauma will determine how the bone fractures. Individuals of any age and gender may suffer this type of fracture. Individuals who suffer from osteoporosis, or the weakening of bone tissue, may have an increased risk of fracture during any traumatic event.

Diagnosis

Proximal humerus fractures are diagnosed by a thorough physical examination and diagnostic imaging. An x-ray is often taken to confirm the fracture.

If further information is needed, such as investigating if any soft tissues are also injured, an MRI or CT scan may be required.

Treatment

Surgical intervention for proximal humerus fractures involves realigning and fixing the fractured bone segments using screws, plates, or rods.

If there is more severe damage to the shoulder joint, a more advanced surgical procedure may be needed.

Plating for proximal humerus fracture

Symptoms

Pain

Swelling

Severely restricted movement of the shoulder

Numbness and tingling in the arm, forearm, or hand

Deformity (an unusual appearance) of the upper arm

Bruising