More severe injuries of the proximal humerus may require surgical measures. With proximal humerus fractures, the majority are treated with a sling for 2-3 weeks and then exercises to regain function of the arm. Fractures which occur to the middle portion are called mid-shaft fractures and those along the lower portion are distal humerus fractures. Fractures which occur close to shoulder joint, injuring the ball and socket are proximal humerus fractures. Humerus fractures are named based upon the location of their fracture. There are many muscles, ligaments, and nerves found along the humerus. In younger patients, your surgeon may recommend removal of the hardware or other surgery.The humerus is the long bone of your upper arm. In older patients, shoulder replacement may be recommended if pain becomes too severe. These complications can occur with or without surgery. Some people may develop arthritis and this can result in increasing pain and stiffness. While most proximal humerus fractures heal, some may not heal or may heal in a position that causes discomfort or limits motion. Your shoulder may always feel and move differently compared to your uninjured side. You may require several months of physical therapy to be able to return to your prior activities. Long-term issues after fracture of the proximal humerus can include stiffness, soreness, and an inability to regain full, pre-injury strength. For best results, it is important to follow instructions from your surgeon. Your ability to move your shoulder and lift more weight will improve as your bone heals. It is important to remove the sling several times a day and to move your elbow, wrist, and hand to prevent stiffness. Often, you will be prescribed physical therapy to help with motion, lifting, and pain after surgery. Many surgeons will ask you to avoid certain movements after surgery until the bone has begun to heal. This may be due to pain and/or instructions from your surgeon. While your proximal humerus fracture is healing, you will likely not be able to fully move your shoulder or lift objects that weigh more than 1 or 2 pounds. If your shoulder has broken into too many pieces and is unlikely to heal even if put back together, your surgeon may recommend replacing your shoulder instead of repairing it.įigure 6: X-rays of a 3-part proximal humerus fracture before and after surgery. If surgery is chosen, the surgeon will make a cut over your shoulder, realign your bones, and use metal plates and screws to repair the broken bone. Otherwise, there are few absolute reasons to do surgery. You may also need surgery if your shoulder is dislocated. Surgery is required if the bone came through your skin (open fracture) or is close to breaking through the skin. An orthopaedic surgeon can discuss your specific injury and the pros and cons of surgery vs. Some proximal humerus fractures benefit from surgery. This decision will be made by your doctor based on your specific fracture. If surgery is not needed, there may be a time during which movement and lifting is limited. Even if surgery is performed, recovery of full function often takes as long as 18 months. During this time, you will need to perform exercises to regain range of motion, strength, and return to normal activities. The broken bone will take 3 to 4 months to heal. Most proximal humerus fractures can be treated without surgery. You should make an appointment with an orthopaedist or your primary care doctor for follow-up. It is important to move your elbow, wrist, and hand to prevent stiffness. Lying flat in a bed after a proximal humerus fracture can cause pain, so it may be more comfortable to sleep in a recliner chair. Unless you have other injuries, most of the time you will be able to go home and will not be admitted to the hospital. When you first see a doctor, he or she will examine your shoulder and arm, and x-rays will be taken. You may even have bruising in your hand or even fingers. There may be a lot of swelling and bruising in your armpit, your chest, and down your arm. Proximal humerus fractures usually hurt a lot, especially when you try to move your arm. Disaster Management and Emergency Preparednessįigure 4: Fracture lines separating (breaking) the proximal humerus into 2, 3, or 4 parts.OTA Support of Federal Grant Applications.Video Library: Annual Meeting & Conferences.
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