A proximal humerus fracture is a common type of injury that Dr. Holloway and his team see when assessing patients with acute traumatic injuries. This type of fracture occurs when a break develops in the upper part of your arm bone (humerus), oftentimes right at or near the shoulder joint. It is a common mechanism of injury in falls onto an outstretched arm or when someone braces for impact during a car accident.
Proximal humerus fractures can be treated in a few different ways based on the location and severity of the break. In today’s blog, we explore a few of the different treatment methods that may be used to fix your proximal humerus fracture.
Treating Proximal Humerus Fractures
Your shoulder specialist will assess your proximal humerus fracture with a physical exam and an X-ray or similar imaging technique to determine the optimal treatment path. Let’s look at some of the less invasive treatment options and work our way to the more involved care options.
- Nonsurgical Management – For stable and non-displaced proximal humerus fractures, you may be able to make a strong recovery with conservative care options. Your arm and shoulder will be protected in a sling for an extended period before you gradually take on more movements with the help of physical therapy. This is the ideal course of treatment because surgical risk doesn’t enter the picture, but it’s only available for mild or standard fractures. More complex injuries will need to be addressed surgically.
- Open Reduction and Internal Fixation – This procedure, also known as a plate and screw fixation, involves the insertion of a metal plate and screws in the area to hold the fractured bones in place so that healing can occur in the correct manner. For complex and displaced proximal humerus fractures, this is typically the preferred surgical method because it’s a relatively straightforward procedure that tends to produce effective healing results. After surgery you will follow many of the protocols that are pushed in the conservative care plan, including bracing, resting and physical therapy.
- Hemiarthroplasty – For more severe and complex proximal humerus fractures, a hemiarthroplasty may be performed. This was a more standard treatment for complex fractures prior to the advancement of the next treatment on this list, but now the hemiarthroplasty is less common. This procedure involves replacing a damaged humeral head with an artificial component to ensure ideal fit and movement after a complex fracture. It’s more likely that your surgeon will recommend the last treatment over a hemiarthroplasty, but for a subset of patients, this still ends up being the ideal way to care for a complex proximal humerus fracture.
- Reverse Total Shoulder Replacement – Finally, if you’re dealing with a complex fracture and other factors like additional injuries or an advanced age, your doctor may recommend that they replace the damaged components with the help of a reverse shoulder replacement procedure. This surgery reverses the standard location of the ball and socket in the joint and replaces them with artificial components. This reversal is particularly helpful if there is damage to the rotator cuff, as the reversal procedure leans on the deltoid muscle for shoulder function instead of the rotator cuff. Many people find their ability to perform overhead and extended motions with their shoulder is restored with the help of a reverse shoulder replacement, but it’s not all that common for a proximal humerus fracture to require such involved care.
If you believe you’re dealing with a proximal humeral fracture or an assessment at an emergency care facility has revealed this injury, know that you should consult with a specialist before determining your best path forward. For help with this decision or for assistance managing other types of shoulder injuries, connect with Dr. Holloway and his team today at (865) 410-7887.
