Proximal humerus fractures are common injuries that occur in the upper arm near the shoulder, typically involving the humeral head, greater tuberosity, or lesser tuberosity. They are particularly prevalent in older adults, often resulting from low-energy falls, as well as in younger individuals due to high-energy trauma such as sports injuries or vehicular accidents. These fractures can be classified according to the Neer classification system, which categorizes them based on the number of fragments involved and the degree of displacement. The degree of displacement is crucial for determining the treatment approach; such fractures can be non-displaced, minimally displaced, or severely displaced. In non-displaced fractures, where the bone fragments remain aligned, conservative management such as immobilization in a sling, followed by physical therapy, is often sufficient. Conversely, displaced fractures, especially those with significant angulation or involving the rotator cuff insertion sites, may require surgical intervention, which can include options like open reduction and internal fixation with plates and screws, or shoulder arthroplasty in cases of severe trauma. The symptoms of a proximal humerus fracture typically include shoulder pain, swelling, and limited range of motion, making daily activities challenging. Diagnosis is primarily based on clinical evaluation and imaging studies, with X-rays being the first-line modality to assess the fracture type, followed by CT scans for more complex cases to better understand fragment displacement and joint involvement. Complications can arise from both the fracture and subsequent management, including adhesive capsulitis, avascular necrosis of the humeral head, and nonunion. These complications can lead to chronic pain and functional impairment, necessitating close monitoring and possible additional interventions. Rehabilitation plays a critical role in recovery, emphasizing the importance of restoring shoulder function and strength through guided physical therapy regimens tailored to the patient's specific fracture type and surgical history. Early mobilization is encouraged to minimize stiffness while ensuring adequate healing. In elderly patients, the presence of comorbidities and bone quality is essential in guiding treatment decisions, as osteoporosis can significantly affect healing outcomes and the risk of future fractures. Ultimately, the management of proximal humerus fractures involves a multidisciplinary approach, including orthopedic surgeons, physical therapists, and primary care providers, to optimize patient recovery and maintain shoulder function. Recognizing the significant impact of these types of fractures on individuals' quality of life underscores the need for timely intervention, patient education on fall prevention strategies, and ongoing research into innovative treatment options and rehabilitation techniques. Through a comprehensive understanding of the nature of these injuries and their appropriate management, healthcare professionals can enhance patient outcomes and improve overall functionality post-fracture.
