Proximal humeral fractures are a common fracture type in the shoulder region, especially among older adults. Managing these fractures takes a little more care and attention when it occurs in an older adult, and we’ve helped countless patients successfully overcome these types of fractures. In today’s blog, we take a closer look at proximal humeral fractures in older adults and the common management strategies we recommend.
Causes And Risk Factors For Proximal Humeral Fractures
A proximal humeral fracture involves a fracture in the upper portion of the humerus, typically just below the ball of the shoulder joint. While it can occur as a result of different types of acute trauma, the most common incident that leads to this fracture pattern is a same-level fall onto an outstretched arm. As you attempt to brace yourself and protect more vital areas of your body like your head or chest, your arms end up absorbing much of the force of the fall, and if this stress overloads part of the humerus, a fracture can develop.
This type of fracture pattern is especially common in older adults for a number of different reasons. For starters, people over the age of 65 are at a much higher risk for falls than younger adults. Perhaps their balance has become worse, they have poor eyesight or they have other physical limitations that increase their fall risk. Since this is the group with the largest fall risk, and falls are the most common cause of proximal humeral fractures, it’s easy to see why these fractures are common in older adults.
But age alone isn’t the only risk factor for proximal humeral fractures. Other risk factors include:
- Osteoporosis
- Osteopenia
- Diabetes
- Epilepsy
- Poor dietary habits and vitamins consumption
- Sex (Women twice as likely to suffer this fracture)
Treating Proximal Humeral Fractures
Fortunately, most proximal humeral fractures can be treated with conservative management techniques, but it will depend on a few different factors, including the size, location and displacement of the fractured bones. Stable fractures will first be managed with non-operative techniques, but if the bone fragments are unlikely to heal correctly on their own, a minimally invasive corrective procedure may be ordered.
- Conservative Treatment – Conservative management will likely begin by placing the arm into a sling to limit movement for the first few weeks. This will help protect the bone from additional trauma and make it easier on the body to begin the healing process by limiting movement that could lead to increased localized inflammation. After a few weeks, you’ll be granted the green light to begin some physical therapy exercises. This helps you build strength, stability and function in the shoulder region. Most patients can expect to be in a sling for about four weeks, and total recovery typically occurs around 10-12 weeks assuming they continue to follow their PT protocol.
- Surgery – After the displaced bones are stabilized during your operation, you can expect to follow a very similar recovery protocol. Most patients will be placed in a sling and told to not bear any weight through their arm for the first 4-6 weeks. After you’ve been cleared for some movements, you’ll connect with a physical therapist and pursue weeks of physical therapy to regain function in the area. You can return to most normal activities by three months post-op, but that timeline may be longer for older adults who face some age-related recovery challenges.
We can help you find the right treatment course if you’ve suffered a proximal humeral fracture. For more information, or for help with a different shoulder ailment, reach out to Dr. Holloway and his team today at (865) 410-7887.
