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Complex proximal humerus fractures

What are Complex Proximal Humerus Fractures?

Proximal humerus is the term given to the upper end of the arm bone.  The upper end of the arm bone along with the dish like cup in the shoulder blade bone forms the shoulder joint.  If there is a fracture in this part of bone it is called as Proximal humerus fracture or sometimes called as Neck of humerus fracture.

Proximal humerus takes part in forming the shoulder joint and also gives attachment to the important muscle of the shoulder called rotator cuff muscles.  The rotator cuff muscles are important in elevating and rotating the arm. Hence a complex fracture occurring in this region can severely affect the function of the shoulder joint.

What causes it?

Fracture occurs after an injury.  This can be as a result of fall or a road traffic accident.

What are the symptoms /effects?

Fracture leads on to severe pain, swelling and deformity of the shoulder joint.  It is difficult to move the shoulder due to pain.

How is it diagnosed?

A clinical assessment and doing investigation such as X ray will confirm the diagnosis.  Sometimes a CT scan of the shoulder will be needed to exactly delineate the complexity of the fracture and also to plan on the appropriate treatment.

What are the treatment options?

Initial treatment is to give adequate pain relief by giving painkiller medicines.  Resting the arm in a sling will give some comfort.

Majority of the fractures occurring in the proximal humerus are simple fractures.  If the broken fragments of a fracture are in continuity and the alignment of the upper arm is in acceptable condition, then the treatment for these fracture will be resting on sling until the fracture starts healing.  This will be usually a period of 6 – 8 weeks.  Then the sling can be taken off and further mobilization can be encouraged.