Proximal Humerus Fractures
Shoulder surgery performed by an Adelaide-based orthopaedic specialist
Proximal humerus fractures occur near the top of the upper arm bone, close to the shoulder. Due to osteoporosis, these fractures are common in older adults and can significantly impact shoulder function. Dr Oscar Brumby-Rendell, an orthopaedic surgeon in Adelaide, has experience treating proximal humerus fractures, offering advanced and personalised care to ensure optimal recovery.
Causes of Proximal Humerus Fractures
Proximal humerus fractures can occur for various reasons, each with different implications for treatment and recovery.
Proximal humerus fractures occur when the upper part of the arm bone (humerus) near the shoulder joint breaks. These fractures are most often caused by trauma such as falls, accidents, or sports injuries. In older patients, osteoporosis increases the risk, while in younger individuals, higher-energy trauma is usually the culprit. Pathological fractures can also occur when weakened bone breaks due to underlying medical conditions like cancer or metabolic bone disease.
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Trauma: Falls, motor vehicle accidents, and sports injuries.
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Direct impact: Forceful blows to the shoulder or upper arm.
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Pathological fractures: Bone weakened by disease processes.
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Types of proximal humerus fractures
Fractures are classified by how the bone breaks and whether the pieces remain aligned.
The severity of the fracture influences the treatment plan.
Non-displaced Fractures:Â
- These occur when the bone cracks but remains in its original anatomical position.
- The treatment plan for non-displaced fractures generally focuses on maintaining the alignment of the bone while it heals naturally.
Displaced Fractures:Â
- In this type, the bone breaks into two or more pieces and shifts out of alignment.
- Displaced fractures may necessitate surgical intervention to realign and stabilise the bone.
Comminuted Fractures:Â
- These fractures occur when the bone shatters into multiple fragments.
- Due to their complexity, comminuted fractures often require intricate surgical fixation. This may involve the use of plates, screws, or rods to piece the bone back together.
Fracture dislocation
- This severe type of injury involves both a fracture and a dislocation of the shoulder joint.
- Treatment for fracture-dislocations typically requires surgery to address both the fracture and the dislocation simultaneously.
Dr Oscar Brumby-Rendell's extensive expertise in treating proximal humerus fractures allows him to tailor each treatment plan to the individual needs of his patients, ensuring the best possible recovery and return to normal activities.
Break free from the limitations of a clavicle fracture with the expert care of Dr Oscar Brumby-Rendell. Contact us today to start your personalised treatment journey.
Symptoms of Proximal Humerus Fractures
The main signs of a proximal humerus fracture are pain and loss of function. Patients often describe sharp pain immediately after injury, with swelling and bruising around the shoulder. In more severe cases, deformity or abnormal shoulder position may be visible.
Common Signs and Symptoms:
- Severe Pain in the Upper Arm or Shoulder: The most immediate and noticeable symptom is intense pain in the upper arm or shoulder region. This pain can be sharp, throbbing, or aching and worsens with movement or pressure.
- Swelling and Bruising Around the Shoulder: Swelling typically occurs soon after the injury due to inflammation and internal bleeding. Bruising may develop within a few hours to days, spreading around the shoulder and upper arm. The area may feel warm and tender to the touch.
- Inability to Move the Shoulder or Arm: Due to the severe pain and disruption of the bone structure, patients often find it difficult or impossible to move their shoulder or arm. This loss of function can be partial or complete, depending on the fracture's severity and surrounding tissue involvement.
- Visible Deformity in Severe Cases: In more severe fractures, the shoulder may have a visible deformity or abnormal shape. This could include the arm appearing out of alignment or shorter due to the displacement of bone fragments.
How to Identify a Proximal Humerus Fracture:
- Sudden Onset of Pain Following Trauma: A proximal humerus fracture often follows a specific traumatic event, such as a fall, a direct blow to the shoulder, or a high-impact accident. The pain usually starts immediately after the injury and can be severe enough to prevent further arm use.
- Difficulty Lifting the Arm: One key indicator of a proximal humerus fracture is the sudden difficulty or inability to lift the arm. This symptom is due to the disruption of the shoulder's standard mechanics and the pain associated with the fracture.
- Audible Snap or Crack at the Time of Injury: Patients might hear or feel an audible snap or crack at the moment of injury, a classic sign of a bone fracture. This sound results from the bone breaking and can be accompanied by immediate sharp pain.
- Immediate Swelling and Bruising: Swelling and bruising are common and usually appear quickly after the injury. Swelling is due to the body's inflammatory response, while bruising is caused by bleeding from the broken bone and damaged blood vessels.Â
Treatment Options for Proximal Humerus Fractures
Non-Surgical Treatments:
Many proximal humerus fractures, particularly stable or non-displaced ones, can be treated without surgery. These approaches focus on immobilisation, pain control, and gradual rehabilitation.
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Rest and immobilisation: Use of a sling to protect the shoulder during healing.
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Pain management: Medication to relieve discomfort and reduce swelling.
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Physical therapy: Gentle exercises to restore strength and movement once healing allows.
Surgical Treatments:
Indications for Surgery: Surgical intervention is considered when fractures are severely displaced, involve the joint surface, or fail to respond adequately to conservative treatment. Other indications include fractures associated with neurovascular compromise or those affecting active individuals who require early return to function.
Types of Surgical Procedures:
- Open Reduction and Internal Fixation (ORIF): This procedure involves surgically realigning fractured bone fragments and stabilising them with specialised implants such as plates, screws, or intramedullary rods. ORIF is preferred for fractures that are significantly displaced or involve the joint surface, aiming to restore anatomical alignment and facilitate early rehabilitation.
- Shoulder Replacement: When the proximal humeral head is severely damaged, particularly in older patients with osteoporosis or complex fractures, shoulder replacement (hemiarthroplasty or total shoulder arthroplasty) may be considered. This procedure involves replacing the damaged humeral head with a prosthetic implant to restore joint function and alleviate pain.
Post-Surgical Care:
After surgery, patients are usually placed in a sling and monitored closely. Pain management, wound care, and gradual return to movement are key aspects of recovery. Follow-up appointments and X-rays help ensure proper healing.
Discover the best treatment options tailored to your needs. Consult with Dr Oscar Brumby-Rendell to explore both non-surgical and surgical solutions for humeral shaft fractures. Contact us today!
Frequently Asked Questions (FAQs)
Healing time varies but typically ranges from 6 to 12 weeks. Factors influencing recovery include the severity of the fracture, the patient's age and overall health, and adherence to rehabilitation protocols.
Recovery and Rehabilitation
Rehabilitation is a vital step in recovery from proximal humerus fractures. Early guided exercises prevent stiffness and gradually rebuild strength. Physiotherapy plays an essential role in regaining shoulder mobility and function. Recovery timelines vary, but many patients see improvements within a few months, with full healing often taking 6–12 months.
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Progressive exercises tailored to healing stage.
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Strengthening therapy for shoulder stability.
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Gradual return to normal activities with medical clearance.
Why Choose Dr Oscar Brumby-Rendell?
Dr Oscar Brumby-Rendell is driven by a commitment to excellence, a passion for his work, and dedication to achieving the best possible outcomes for patients. He ensures personalised care, ensuring patients receive treatment tailored to their unique circumstances and needs.Â
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