Orthopedic Center with Orthopedist and Arthroplasty Services

Fracture of the proximal humerus

The humerus bone runs all the way from the shoulder to the elbow. Fractures of this bone are usually the result of falls and trauma and can occur for people of any age. However, older and young people tend to be more prone to proximal humerus fractures.

If your child has sustained this injury, schedule an appointment with our pediatric orthopedist at our Arthroplasty clinic.

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What are proximal humerus fractures?

When the region close to the humerus sustains trauma from an injury or fall, a fracture of the proximal humerus is often the result. This causes a rupture of bone structures, dividing the bone into two or more fragments upon impact.

The third most common fracture

Proximal humerus fractures are among the most common fractures that you can sustain. While it predominantly affects elderly people owing to bone degeneration, an injury or major impact to the region can affect anyone.

In the case of people over the age of 50, the fracture is related to osteoporosis and low-energy trauma, such as domestic falls. Young people may not have to worry about these factors, but there are other reasons they may sustain this injury. These causes are related to high-energy trauma, such as automobile and sports accidents.

How is it diagnosed?

Diagnosis is at the heart of effective treatment and rehabilitation. Diagnostic tests are fundamentally important to assess and determine the best treatment option for your needs and lifestyle.

The three main types of diagnostic tools used at our clinic are:

Physical examination: a simple physical examination can provide surface-level information regarding the injury and its symptoms. We assess any painful areas, difficulties in limb movement and mobility, edema, and bruising in the shoulder region.

However, this provides only cursory information regarding your fracture. We often recommend our patients to be referred for an X-ray that provides more in-depth information.

Radiological: Radiography is a primary and vital examination to detect the fracture. This provides greater insight into the affected region, the extent of the injury, and helps us determine the kind of treatments needed.

Tomographic: The computed tomography exam—also referred to as a CT scan—is necessary for more complex cases. This is because some fractures may not appear during the radiography diagnostic test. These “hidden fractures” can be seen through CT scan’s three-dimensional assessment procedure that allows for a more holistic view of the injured region.

What are the types of fractures in the proximal humerus?

There is a very wide variety of fractures that can occur in this region. Fractures can occur on different parts of the bone and may or may not be deflected. The greater the number of parts and deviations of the fragments, the more severe the fracture.

In general, fractures of the proximal humerus are classified according to the number of fragments they present and their possible deviations.

Fracture severity
There are various other criteria that determine the severity of the fracture and are evaluated by the doctor to determine the best treatment. The presence of dislocation of the humeral head and fracture with a step in the joint are also factors of greater severity.

What are the treatments indicated?

Depending on the diagnosis, treatments can be surgical or non-surgical (conservative):
Non-surgical treatment (conservative): About 80% of fractures of the proximal humerus do not cause the bone to deviate from its anatomical position. Hence, they can be treated without the need for surgical intervention.

To perform the conservative procedure, we start by immobilizing the shoulder using a sling. Depending on the bone’s healing and extent of injury, the duration you’ll need to use the sling may vary.
Surgical treatment: These procedures are required in more serious situations when there has been a severe misalignment of the fracture fragments or in cases where the fracture is accompanied by dislocations. The type of surgery performed for such fractures will depend on each case and its specifications, this includes factors such as the patient’s age and bone quality.

We may perform the surgical procedure for the preservation or replacement or the bone. In the latter case, we place the prosthesis of the proximal humerus in the affected region.

What are the main complications?

There may be several complications in the case of these fractures, whether you opt for surgery or not. The most common complication is a loss of shoulder mobility and movements. This may depend on various factors, such as: prolonged immobilization time, the severity of the fracture, and position of bone fragments after consolidation.

Other complications

You may experience other complications along the way, such as pseudarthrosis (when the fragments do not join), infections, and osteonecrosis (of the humeral head). Patients also frequently experience limb stiffness owing to the lack of movement. Hence, rehabilitation is essential to regain your functionality and mobility.

Recovery

Rehabilitation programs are essential to improving the movement of the shoulder and elbow joints. Additionally, it contributes to improving the muscle strength of the arm.

Recovery also includes an immobilization period that’s followed by a period of physiotherapy. You need to wait a minimum of three months before you can begin your usual activities, regardless of whether the treatment was surgical or not.

Before you decide on a procedure, consulting with an orthopedic doctor is essential. Our team can guide you on the most effective diagnostic procedures and treatments. Get in touch with us to schedule your appointment.

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Nossa Estrutura

Unidade Higienópolis

Sala de espera com amplo espaço e conforto para a família que espera por uma consulta de ortopedia geral ou ortopedia infantil.

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Unidade Higienópolis
A clínica Artroplastias do ortopedista em São Paulo, Dr. Felipe possui sala para acolher o paciente e família.

   +55 (11) 99452-6862
celular +55 (11) 99949-4566

Unidade Higienópolis

Sala para um exame ortopédico completo, cujo objetivo é o diagnóstico preciso. A indicação de uma artroplastia de quadril se baseia no estudo clínico e radiográfico cuidadoso do paciente.

+55 (11) 99452-6862
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