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By: Dr. Kamal Bohsali and Rachel Consolazio, PTA
A proximal humerus fracture is the medical terminology for a “broken shoulder”. The humerus is the
large upper arm bone that connects the elbow joint to the shoulder. The term, proximal, refers to the
end of the bone that is situated closer to the shoulder, ball-and-socket joint. The proximal end of the
humerus is the most commonly fractured area of the bone when an injury occurs.
Proximal humerus fractures occur more frequently in the older population than younger people due to
the weakening of their bones with age and decreased bone density (osteopenia and osteoporosis). These
fractures often occur when a person falls and takes most of the impact through their arm. The bone can
break in a variety of ways.
A doctor would need to have an x-ray of your shoulder to see how the bone broke. It can break completely through the bone, splitting the bone into two or several pieces or a section (the lesser or greater tubercle) of the bone could fracture or break off.
This type of injury can be very painful and will restrict the ability to use the affected arm. There is
typically swelling and bruising on the upper arm and armpit area. Initially the fractured humerus will be
treated by immobilizing the arm in a shoulder sling, ice, and pain medication.
Once an orthopedist has examined the x-rays, they will determine if the proximal humerus fracture is displaced (meaning the bones have slipped from their normal position in the body) or non-displaced. If the bone has broken into several pieces or is displaced, a surgeon may need to operate to place screws and a plate on the bone to hold it in place and allow it to heal properly. In some cases, the shoulder joint may need to be replaced due to the severity of the fracture. Most proximal humerus fractures are non displaced and can be treated without surgical intervention.
Bone heals at different rates depending on the individual’s age and other health factors. During the healing process, an orthopedist may recommend 2 to 3 weeks of immobilization and pain control, while maintaining motion of the elbow, wrist, and fingers to increase circulation and prevent stiffness. A follow-up appointment will need to be scheduled at which new x-rays will be taken to ensure that the bone has healed or is healing at the rate it should be. At this appointment, the doctor will typically refer the patient to physical therapy for range of-motion exercises and to have the shoulder stretched by a therapist. Once the bone has healed completely, at about 12-16 weeks, the physical therapist will progress treatment with gentle strengthening exercises. A patient may require several months of therapy to regain full range of motion and functional strength of the involved arm.
Passive Shoulder Flexion
Table Slides and Shoulder Scaption
There can be long term issues following a proximal humerus fracture, as with any major injury. Chronic
pain or soreness with over-activity, stiffness, and loss of mobility are all issues that can remain months if
not years after this type of injury. If you follow the orthopedist recommendations and attend therapy
as prescribed, you should be able to make a full recovery.
If you have and injury or possible fracture, the Jacksonville Orthopaedic Institute can help. To see a JOI Orthopedic doctor, call (904)JOI-2000, schedule online, or click the link below. The see a JOI Rehab Therapist in 1 of our 12 locations, call (904)858-7045.