Proximal Humerus Fracture (Shoulder)

Description

This is a break at the top of the humerus (upper arm bone), near the shoulder. It often involves the growth plate there and usually follows a fall. It is a forgiving fracture in children.

How it happens (the mechanism)

A fall drives force into the top of the arm bone, near or through the shoulder growth plate. That growth plate is one of the most powerful in the body — about 80% of the arm bone’s growth comes from there — so even fairly crooked breaks remodel and straighten themselves out over time, especially in younger children. The more growth a child has left, the more the body quietly corrects.

Symptoms

Pain, swelling, and tenderness at the top of the arm near the shoulder, with reluctance to lift the arm.

Doctor examination and imaging

The doctor checks the shoulder and the arm’s circulation and feeling; X-rays show the fracture and its angle.

Treatment

The large majority are treated with a sling or shoulder immobilizer for comfort for a few weeks, then gentle motion. Because of the tremendous remodeling here, a good deal of angulation can be accepted. Surgery is reserved for the unusual severely displaced fracture in an older teen.

Recovery and long-term outlook

Most heal beautifully without surgery, with full shoulder function.

When to call the doctor

Call if pain is severe or worsening, your child will not use the arm at all, the area becomes very swollen, red, or warm, your child develops a fever, or things are not improving as expected.

Learn more

OrthoInfo (AAOS) — Growth Plate Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.