What is a proximal humerus fracture?

A proximal humerus fracture is a break in the upper end of the humerus, the part of the arm bone that forms the shoulder joint.

How long does a clavicle fracture take to heal?

Collarbone fractures typically achieve bony union within 10 weeks in adults, though this can take longer with displaced fractures or in older patients. A sling is worn for comfort during the initial weeks. Rehabilitation begins early to maintain shoulder movement and is intensified, when clinically appropriate, to restore full shoulder function. Return to contact sport is typically guided by bony union and restoration of strength.

Does a clavicle fracture need surgery?

The majority of collarbone fractures, including most displaced mid-shaft fractures, heal well with non-operative management. Surgery is considered for fractures with significant shortening, complete displacement with skin tenting, open fractures or non-union. Plate fixation allows earlier mobilisation and return to sport but carries risks of implant irritation and a second procedure for plate removal.

What is a reverse total shoulder replacement and when is it used?

A reverse total shoulder replacement reverses the normal ball-and-socket configuration, placing the ball on the glenoid side and the socket on the humerus. It is used for complex proximal humerus fractures in older patients and for advanced rotator cuff arthropathy.

Shoulder Conditions

Shoulder Fractures

Overview

What are Shoulder Fractures?

Shoulder fractures most commonly involve the proximal humerus (the upper end of the arm bone), the clavicle (the collarbone) and less frequently the scapula (the shoulder blade).

Management ranges from non-operative treatment in a sling for stable, minimally displaced fractures to complex surgical fixation with plates, nails or shoulder replacement for severe fractures. Regardless of treatment, specialist rehabilitation is essential. The shoulder is highly susceptible to stiffness following injury, and without appropriate Hand Therapy a significant proportion of patients are left with permanent functional restriction.

Causes

What causes Shoulder Fractures?

Falls onto an outstretched hand or directly onto the shoulder: the most common mechanism
High-energy trauma in road traffic accidents, cycling and contact sports
Osteoporosis: fragility fractures of the proximal humerus with minimal force in older adults
Direct impact to the clavicle: common in cycling, rugby and equestrian sports
High-energy scapula fractures: typically associated with other significant chest injuries

Symptoms

Signs & symptoms

Severe shoulder pain, swelling and bruising immediately following injury
Inability to lift or use the arm
Deformity of the shoulder or clavicle in displaced fractures
Tenderness at the specific fracture site
Numbness or tingling in the arm if associated nerve injury is present
A step deformity at the shoulder joint

Treatment

How Hand Therapy can help

Ms Razo provides specialist assessment and evidence-based treatment for Shoulder Fractures. Following a thorough initial assessment, a personalised treatment plan will be developed to address your specific needs and goals.

Sling Management & Early Exercises

The majority of proximal humerus and clavicle fractures are managed non-operatively in a sling. Ms Razo initiates early exercises within the first week to safely maintain shoulder movement during the immobilisation period, within the limits of fracture stability.

Progressive Shoulder Mobilisation

As fracture healing progresses, a systematic programme of shoulder mobilisation is introduced, advancing as bony union allows. Early, progressive mobilisation is critical to preventing the capsular contracture that is particularly common following proximal humerus fractures.

Post-Surgical Rehabilitation

Fractures requiring open reduction and internal fixation with plates or intramedullary nails, and those treated with hemiarthroplasty or reverse total shoulder replacement, require specialist post-operative rehabilitation. Ms Razo coordinates with the operating surgeon to design a programme appropriate to the fixation method and fracture pattern.

Strength Restoration

Following fracture healing, progressive strengthening restores the muscle function necessary for full shoulder use. Functional rehabilitation targets the patient's specific goals, from managing daily living activities to returning to sport and manual work.

FAQ

Frequently asked questions

: A proximal humerus fracture is a break in the upper end of the humerus, the part of the arm bone that forms the shoulder joint.
: Collarbone fractures typically achieve bony union within 10 weeks in adults, though this can take longer with displaced fractures or in older patients. A sling is worn for comfort during the initial weeks. Rehabilitation begins early to maintain shoulder movement and is intensified, when clinically appropriate, to restore full shoulder function. Return to contact sport is typically guided by bony union and restoration of strength.
: The majority of collarbone fractures, including most displaced mid-shaft fractures, heal well with non-operative management. Surgery is considered for fractures with significant shortening, complete displacement with skin tenting, open fractures or non-union. Plate fixation allows earlier mobilisation and return to sport but carries risks of implant irritation and a second procedure for plate removal.
: A reverse total shoulder replacement reverses the normal ball-and-socket configuration, placing the ball on the glenoid side and the socket on the humerus. It is used for complex proximal humerus fractures in older patients and for advanced rotator cuff arthropathy.

Ready to take
the first step?

Book a consultation with Ms Razo and receive a thorough assessment, precise diagnosis and a personal treatment plan.

Book a Consultation Or call +44 (0)28 9099 3464