Dr. Carlos Rebollón

Proximal humerus fracture
in Panama

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Proximal humerus fracture

Proximal Humerus Fracture

Proximal humerus fracture, commonly known as shoulder fracture, occurs most frequently in the elderly. Proximal humerus fractures constitute approximately 5% of all fracture cases, being the third most common fracture type in older individuals after hip and wrist fractures.

Many injured individuals achieve good outcomes with early medical attention.


The explanation of a proximal humerus fracture would not be complete without first defining its anatomical structure. The humerus is a long bone that has a proximal end that articulates with the scapula within the shoulder joint and a distal end that connects to the forearm bones (ulna and radius) at the elbow.

Focusing on the proximal end, it should be noted that it has four relevant parts: the anatomical neck, greater tuberosity (trochiter), surgical neck, and lesser tuberosity (trochin).

Proximal humerus fractures occur at the surgical neck, where approximately 80% of these fractures do not involve displaced structures, meaning they have a single fragment and remain stable. Fractures with angulated or displaced structures are known as two-part fractures, while fractures with more than three parts are extremely rare.

The majority of proximal humerus fractures in older individuals occur as a result of a strong fall on the outstretched arm. In younger individuals, they can occur due to sports trauma, traffic accidents, or falls from great heights.


After the trauma, the patient may experience:

Arm and shoulder pain.


Functional limitation of the shoulder.


Inability to move or lift the arm due to intense pain.

Fractura De Humero

Diagnostic process

Traumas like this should be evaluated and treated as soon as possible; therefore, it is highly recommended to seek medical attention within hours of the event. The attending physician will start with a physical examination accompanied by radiological tests (plain X-rays), and computed tomography scans are required when plain X-rays have not shown definitive images or in cases of complex fractures.


In determining the treatment, the following factors should be taken into account: patient’s age, fracture type, degree of displacement, and the presence or absence of associated dislocations.

Fortunately, more than 80% of cases involve a single fragment without displacement, while the remaining percentage corresponds to unstable fractures with displacement, which will require more complex treatment.

Therefore, the treatment can vary between conservative or surgical, depending on each particular case. Here are some of the most common options:

Ambulatory immobilization with a sling, medication, and range of motion exercises.

Open reduction with internal fixation (osteosynthesis).

Intramedullary nailing.

Shoulder arthroplasty.

Rehabilitation process after this fracture

After a proximal humerus fracture and its respective treatment (surgical or non-surgical), it is essential for the patient to follow a rehabilitation plan, which is generally a lengthy process taking between 6 months and a year. During this time, the patient will go through different phases, including passive and active mobility stages, strength recovery, and functional readaptation to resume their usual activities.

The responsible specialist will monitor the patient’s progress through clinical follow-ups, periodically evaluating the fracture’s consolidation through X-rays.

Que Es La Fractura De Humero Proximal Y Como Se Puede Producir
Como Dormir Con Fractura De Humero


The most important aspect when trying to fall asleep with a proximal humerus fracture is the posture. The first thing to avoid is blood pooling in the injured area, which is why the arm should always rest in a position higher than the heart.

The most recommended position is to sleep on your back with pillows behind your back and neck to achieve some elevation. You can also try sleeping on your side, resting on the unaffected arm. It is important to remember that the use of a sling is mandatory during the day and night, so it cannot be omitted while sleeping.

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