A proximal humerus fracture involves a break at the top of your upper arm bone. Oftentimes the fracture occurs just below the ball of the shoulder joint, and it commonly occurs in older adults when attempting to brace themselves with their arms outstretched during a fall. These types of fractures account for roughly five perfect of all fractures in an adult population, and Dr. Holloway has helped a number of patients recover from this type of injury. In today’s blog, we take a closer look at how proximal humerus fractures are diagnosed and treated.
Diagnosing A Proximal Humerus Fracture
The proximal humerus is the ball of your shoulder joint, and it is the bone that allows you to move your shoulder in a number of different directions. Your rotator cuff muscles are attached to this bone, and a number of important blood vessels and nerves run nearby, which is why it is so important to have your shoulder injury assessed by a professional. Not only could you be dealing with a fracture, but these crucial tissues will also need to be evaluated for injury.
If you’re presenting to the emergency room or urgent care with pain and decreased mobility in your shoulder, the care team will ask about the incident and conduct a physical examination of the shoulder area. Sometimes the humerus can fracture in such a manner that the bone breaks through the skin or pushes up underneath the skin without breaking through.
If a shoulder fracture is obvious or suspected, your doctor will order an imaging test. In most instances, an X-ray can help to evaluate whether or not a proximal humerus fracture exists, where it is located and the severity of the break. Oftentimes a few different X-rays are taken in order to get a better understanding of the fracture pattern. If the bone has broken into many pieces, a CT scan may provide a more detailed look at the totality of the damage. These images also help the doctor chart a treatment course, as these injuries may resolve on their own, or they may require surgical intervention.
Treating Proximal Humerus Fractures
As we noted above, these types of humeral fractures can be treated with conservative or operative means based on the needs of the patient. Here’s a closer look at each technique:
- Non-Operative Care – Fortunately, most proximal humeral fractures heal on their own without surgery, especially if there is minimal fracture displacement. In these instances, your doctor will oftentimes recommend a combination of immobilization and regular monitoring before progressing through weeks of physical therapy and range of motion exercises once enough healing has taken place. In many instances, patients are back to performing routine tasks with their arm after six weeks of care, but return to full activities can take up to 3-4 months.
- Surgical Care – If the bones are too far apart, the bone has broken through the skin, the fracture is in too many pieces or there was damage to nearby nerves and blood vessels, your doctor may recommend a corrective procedure. Surgery typically involves the insertion of hardware like plates or screws to help hold the bones in the correct location while healing runs its course. After surgery, patients will follow a care plan similar to those pursuing non-operative means, which involves immobilization, watchful monitoring and weeks of physical therapy. Your physical therapist will also work with you to ensure you don’t return to athletic activities too quickly, as a refracture is possible if you jump back into physical activity before enough healing has occurred.
Dr. Holloway can provide care or even surgically address your shoulder in the event that you suffer a proximal fracture. If you have questions or concerns about a shoulder injury that you’ve suffered, reach out to his office today at (865) 410-7887 or more information.
