What are treatment options for a proximal humerus fracture (broken shoulder)?

A proximal humerus fracture is a type of broken shoulder – it’s a fracture of the bone that connects your shoulder to your elbow. The blood supply to the proximal humerus is a little unique, and that’s where the treatment options vary. The vast majority of proximal humerus fractures can be treated with some functional braces or casting and without surgery. But up to about 20 percent of this type of broken shoulder will typically have a little better outcome if they’re treated with shoulder surgery.

What are the advantages of shoulder surgery?

Some of the advantages to shoulder surgery over non-surgical (or non-operative) treatment is you can usually start moving the shoulder a little quicker. You take a plate and screws, or rod, and two pieces of bone that are separated, and put them together to move as a single unit. You can start moving the shoulder quicker, therefore less likelihood to develop stiffness of that joint. The shoulder is the joint that has the most range of motion in the human body, but it also tends to want to stiffen up pretty quickly if you don’t move it. If you can move it sooner, and not having bones rubbing against each other or displacing, you have a better chance of getting more range of motion and strength to the shoulder.

What can patients expect after treatment of a broken shoulder?

Patients who have a proximal humerus fracture are in for quite a long recovery, with or without shoulder surgery. Without shoulder surgery it can take 4-6 months for the bone to fully heal. With that process, you have to wear a special functional brace that really you’re not able to raise your arm above your head. The bone is pretty slow to heal – it will heal…the vast majority of them will heal – but it’s pretty slow to heal. With shoulder surgery, you’re moving a little sooner but you’re still not able to lift, throw or carry anything heavy for every bit of six months. Depending on how the X-rays look, later on you can start moving it sooner, but your strength will take up to six months to fully return.

What advice do you have for patients considering shoulder surgery for a broken shoulder?

Take all things in your life into consideration to see if you’re willing to have the risks of shoulder surgery. It’s a big operation in this area. If this is your dominate arm and you want to get back to activities where you are lifting and carrying – possibly even throwing – shoulder surgery is going to be a very real, very good option for you.

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