About Humerus Fractures
The most common fractures of the shoulder that I see in my practice are fractures of the proximal humerus and fractures of the clavicle. Broken upper arms—humerus fractures—usually occur as a result of a fall.
A shoulder practitioner will make the diagnosis of fracture of the humerus or clavicle after obtaining a history, performing a careful examination, and reviewing imaging studies. Plain x-rays are usually sufficient to establish the diagnosis of a humerus fracture or the clavicle.
Most proximal humerus fractures can be treated with immobilization. Immobilization is generally accomplished by the use of a sling and a component of the sling that wraps around the upper body called a swathe. A sling and swathe keep the arm and forearm at the side and is usually sufficient protection for the fracture.
A very small percentage of proximal humerus fractures will require surgery. Surgery is sometimes undertaken in an attempt to put the pieces back in a more proper position and maintain that position with plates, screws, wires, and the like. Sometimes surgery for proximal humerus fractures involves removing the ball of the shoulder and performing a shoulder hemiarthroplasty. A shoulder hemiarthroplasty is a procedure in which the ball the shoulders replaced with a metal ball and the tendons and muscles are reattached so that the new shoulder will work in the best way possible.
A lot of patients are surprised to learn that they do not need to wear a cast to treat a proximal humerus fracture. It’s also fine for the shoulder to have some gentle motion. The bone does not have to be held absolutely still for healing to take place.
I find that most patients will suffer some permanent impairment as a result of a proximal humerus fracture. Most find that their shoulder is stiffer than it was before. Some will develop arthritis years after the fracture as a consequence of the fracture. Most patients are able to return to doing almost everything that they used to do before the fracture occurred.