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.
Trauma is a leading cause, especially falls, which are the most common cause of these fractures, particularly in older adults whose bones may be weakened by osteoporosis. In younger individuals, high-impact trauma, such as car accidents or falls from a significant height, can also lead to fractures.
Direct impact is another common cause of proximal humerus fractures. Sports injuries, especially in contact sports, can cause direct trauma to the shoulder. Additionally, work-related accidents or physical altercations may result in these types of fractures.
Pathological fractures occur in bones weakened by disease, making them more susceptible to breaking even with minor trauma. Conditions such as osteoporosis reduce bone density and strength, increasing the risk of fractures.
Understanding the causes of proximal humerus fractures is crucial for Dr Oscar Brumby-Rendell in developing an effective treatment and recovery plan. He meticulously addresses each case's unique challenges to ensure optimal patient outcomes.
Take the first step towards recovery with personalised care from Dr Oscar Brumby-Rendell. Book a consultation today.
Types of proximal humerus fractures
Proximal humerus fractures can be categorised based on the pattern and extent of the break. Each type requires a different treatment approach, reflecting the injury's complexity and severity. The primary types of proximal humerus fractures include non-displaced, displaced, comminuted, and fracture-dislocations.
Non-displaced Fractures:
- 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:
- 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:
- 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
Often, a proximal humerus fracture is due to a fall or high-energy trauma, and people seek prompt care from an emergency department where x-rays will diagnose the fracture. If the injury is less obvious, recognising the symptoms of proximal humerus fractures can help seek prompt medical attention from Dr Oscar Brumby-Rendell, a leading orthopaedic surgeon in Adelaide.
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.
Treatment Options for Proximal Humerus Fractures
Non-Surgical Treatments:
- Rest and Immobilisation: Resting the affected shoulder is crucial in the initial healing phase. Immobilisation is typically achieved using slings or braces tailored to support the arm and prevent excessive movement that could disrupt healing.
- Pain Management: Managing pain and inflammation is essential for patient comfort and to facilitate rehabilitation. Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics are commonly prescribed. In some cases, corticosteroid injections may be used.
- Physical Therapy: Once initial healing has occurred, physical therapy plays a pivotal role in restoring shoulder function. Therapist’s design tailored exercise programs to gradually increase the range of motion, strengthen muscles, and improve joint stability.
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:
Following surgical intervention, rehabilitation is initiated promptly to optimise outcomes. This includes structured physical therapy to regain shoulder mobility, strengthen muscles, and improve function. Pain management strategies are adjusted according to patient needs and other modalities as recovery progresses. Regular follow-up visits allow clinicians to monitor healing, assess range of motion, and adjust rehabilitation protocols.
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)
Recovery and Rehabilitation
After sustaining a proximal humerus fracture, effective recovery and rehabilitation are crucial to restoring shoulder function and returning to daily activities. The healing process typically begins with 2-4 weeks of initial immobilisation, ensuring the fractured bone stabilises. Over the subsequent 8-12 weeks, a carefully phased approach integrates physical therapy and progressive physical activity to promote healing and restore range of motion and strength.
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.