Proximal Humerus Fractures

A fracture of the proximal humerus is more common in elderly individuals with osteoporosis. However it can occur in any age group if you fall the wrong way.
- Dr Duckworth

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The humerus is the long bone in your upper arm that's located between your elbow and your shoulder. The proximal humerus, is the upper end of the humerus, that forms the shoulder joint.

A fracture of the proximal humerus is more common in elderly individuals with osteoporosis. However it can occur in any age group if you fall the wrong way and land with an outstretched arm. In younger individuals, high energy trauma is generally required to cause these fractures, such as a fall from a bike, horse or skiing.

Learn more about proximal humerus fracture surgery

Fractures of the upper arm can sometimes be treated without surgery and can heal well with simple immobilization in a sling. However, patients that have a displaced fracture may require surgery as seen in the CT scans below. This humerus has fractured just below the ball and has displaced with significant angulation. It was fixed with plate and screws as seen below.

$CT scan showing proximal humerus fracture$

$Xray showing plate and screws proximal humerus fracture surgery$

The images below show a fracture in three pieces which required a long plate and screws to stabilise the fracture.

$CT scan showing proximal humerus fracture$

$Xray showing plate and screws proximal humerus fracture surgery$

How is a diagnosis made?

Proximal humerus fractures are diagnosed by history, physical examination and imaging of the affected area ( X-ray and/or computerized tomography (CT) scan). In the fracture below the whole shaft of the humerus has become separated from the ball. This required fixation with an intramedullary pin and screws.

$CT scan showing proximal humerus fracture$

$Xray showing plate and screws proximal humerus fracture surgery$

Signs and Symptoms

Patients with proximal humerus fractures can experience pain, sleep disturbance, swelling, and restricted motion of the shoulder. Bruising may extend across the chest wall and down the arm. It is not unusual for your whole arm to become swollen due to gravity.

$X-ray showing proximal humerus fracture$