Proximal Humerus Fracture Surgery

Proximal humerus fractures often require surgical interventions, and the choice of surgery depends on the fracture type, patient’s overall health, and lifestyle.

  1. Open Reduction and Internal Fixation (ORIF): This procedure involves repositioning the broken bone fragments into their normal alignment and then holding them together using internal fixings such as screws, wires, or plates. The surgery aims to restore the original anatomy and enable natural healing.
  2. Hemiarthroplasty: In cases where fracture fragments are too shattered for ORIF, hemiarthroplasty may be performed. It involves replacing the fractured humeral head with a prosthesis, preserving the remaining healthy bone and joint structures.
  3. Reverse Total Shoulder Arthroplasty: This procedure is often selected for complex fractures or in elderly patients with poor bone quality. It involves replacing both the humeral head and the glenoid (shoulder socket) with artificial components, but in a reverse design that relies on the deltoid muscle, instead of the rotator cuff, for arm motion.

Expected Surgery Outcome

Successful surgery for a proximal humerus fracture significantly improves pain and restores shoulder function. Though the recovery process may be long, most patients eventually regain a good range of motion and can resume normal activities after surgery and rehabilitation.

Potential surgery complications and risks

Similar to other surgeries, proximal humerus fracture surgeries carry potential complications, including infection, blood clots, adverse reactions to anaesthesia, nonunion, and hardware complications.

Risks

  • Infection: Post-surgery infections can occur, potentially necessitating additional surgery.
  • Blood Clots: Due to immobility after surgery, clots can form in the arm veins, posing serious risks.
  • Nonunion: The fracture may not heal properly, causing persisting pain and functional limitations.
  • Hardware Complications: The fixation devices or prosthetic components used in surgery may cause discomfort or, in rare cases, malfunction, requiring extra procedures.

Recovery after surgery

Following surgery for a proximal humerus fracture, patients usually start physiotherapy within a few weeks to regain strength and range of motion. Pain management medication is generally prescribed. Recovery timelines differ based on the surgery type and the patient’s overall health, but complete recovery typically takes several months to a year.