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From 3 weeks post surgery, after surgeon review, the sling can normally be discarded and gentle range of motion exercises commenced. With surgery there are the additional risks associated with a general anaesthesia (often in the elderly), infection, nerve injury and greater stiffness.įollowing fracture +/- surgery patients are encouraged to maintain sling immobilization and elbow range of motion. Collapse of the humeral head due to a disrupted blood supply is delayed and rare but may require surgery to replace the fragmented joint surface. Other complications from surgical neck of humerus fractures include long-term pain, weakness and loss of function. Maximal range of motion is achieved 12-18 months post fracture +/- surgery. A course of physiotherapy is usually required to assist in regaining a functional range of motion. Regardless of the form of treatment, stiffness (frozen shoulder) after a fractured neck of humerus, is very common. The multiple fragments are fixed with plates, screws, or a joint replacement. Surgery may be necessary in displaced fractures. This involves use of a sling to immobilize the arm and later physical therapy to restore function. Most proximal humerus fractures are minimally displaced and can be treated non-operatively. Proximal humerus fractures are diagnosed by history, physical examination and imaging of the affected area ( X-ray and/or computerized tomography (CT) scan).

Bruising may extend across the chest wall and down the arm.

Patients with proximal humerus fractures experience pain, sleep disturbance, swelling, and restricted motion of the shoulder. Humeral head fractures: Humeral head fractures are rare.Īnother way of describing proximal humerus fractures is by counting the number of displaced fracture fragments (two, three, and four part fractures) The more fragmentation of the proximal humerus, the higher risk of long-term loss of blood supply to the bone supporting the humeral head (avascular necrosis).If left untreated, these fractures cause loss of subscapularis muscle function ( a stabilizer and mobilizer muscle). Lesser tuberosity fractures: These fractures are rare.Surgical neck fractures: Fractures of the surgical neck are most common in patients with osteoporotic bone.

Greater tuberosity fractures are less common and are seen in cases of shoulder dislocations and in those with osteoporosis.