Shoulder fractures commonly involve the proximal humerus (there are other bones of the shoulder that may also break). The proximal humerus may be broken into 2 or more pieces. One of the pieces may include the attachment of the rotator cuff. Nondisplaced (nonseparated) fractures of the proximal humerus are commonly treated with immobilization and serial radiographic (X-ray) assessment to determine whether appropriate alignment remains over time. When fractures are displaced (separated) in younger patients, surgical treatment with open reduction and internal fixation may be necessary. With surgical treatment, the bones are aligned and affixed with an implant. In older patients with significant fracture displacement, multiple fracture fragments, and lower quality bone appearance, arthroplasty may be considered. Specifically, a reverse total shoulder arthroplasty may be an option for these patients. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician. Outcomes after surgery vary and risks and benefits should be discussed in detail with your treating physician.
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician. Individuals who are older and/or sustain broken bones from low energy injuries (i.e. ground level falls) may have an underlying condition called osteoporosis. Osteoporosis involves a condition where bones have decreased mineral density. This creates an increased risk for sustaining a fracture. Treatment options include appropriate dietary vitamin intake and at the direction of a physician more specialized medications. Evaluation and management should be discussed with your treating physician.
Disclaimer: This information is not intended to covey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD
Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.