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Shoulder

Proximal Humerus Fracture

A proximal humerus fracture is a break at the upper end of the arm bone near the shoulder joint. It is among the most common fractures in adults over 60 — often from low-energy falls — and can also occur in younger patients from high-energy trauma or sports collisions. Treatment depends on the fracture pattern and patient activity level.

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Typical Recovery Time
3–6 months for return to full function; 12+ months for complex fractures

Symptoms

  • •Immediate severe shoulder pain after trauma
  • •Inability to lift the arm
  • •Rapid swelling and bruising around the shoulder and upper arm
  • •Tenderness over the proximal humerus
  • •Deformity in displaced fractures

Common Causes

  • •Fall on outstretched hand (most common in older adults)
  • •Direct blow to the shoulder
  • •High-energy trauma (motor vehicle accident, sports collision)
  • •Osteoporosis increasing fracture risk
  • •Pathologic fracture from bone lesion

Treatment Options

1Non-surgical management with sling immobilization for most non-displaced fractures
2Physical therapy beginning at 2–4 weeks
3Open reduction and internal fixation (ORIF) for displaced fractures
4Shoulder hemiarthroplasty or reverse total shoulder for severe comminuted fractures
5Bone density evaluation and treatment in older patients

When to See a Doctor

Any significant shoulder trauma with severe pain and inability to move the arm requires emergency X-ray evaluation to rule out fracture.

Frequently Asked Questions

What is a proximal humerus fracture?
A proximal humerus fracture is a break in the upper part of the arm bone near the shoulder. It is a common injury, especially after falls. The severity can range from mild cracks to more complex fractures.
What causes a proximal humerus fracture?
It is usually caused by a fall onto the shoulder or arm. High-impact injuries and sports trauma can also lead to this fracture. Older adults are at higher risk due to weaker bones.
What are the symptoms?
Symptoms include shoulder pain, swelling, bruising, and difficulty moving the arm. Some people notice deformity or significant weakness. Pain is often worse with any movement.
Do I need surgery?
Many proximal humerus fractures can be treated without surgery using a sling and therapy. Surgery may be needed if the fracture is displaced or unstable. The decision depends on the fracture pattern and patient needs.
How long does recovery take?
Healing typically takes 6 to 12 weeks. Rehabilitation is important to restore motion and strength. Return to full activity depends on healing and function.
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