Proximal Humerus Fractures
A proximal humerus fracture is a break of the top of the upper-arm bone — the ball of the shoulder — most often from a fall, and especially common in older adults with weaker bone.
What is a proximal humerus fracture?
This is a break at the upper end of the arm bone, where it forms the ball of the shoulder joint. Severity varies widely — from a single hairline crack to several displaced fragments. How many pieces there are, how far they have shifted, and your age and activity level all guide treatment.
Symptoms to watch for
- Sudden, severe shoulder pain after a fall
- Swelling and bruising that can spread down the arm and chest
- Inability to move the arm
- Sometimes a visible deformity
How it is diagnosed
X-rays confirm the fracture, and a CT scan is often added when surgery is being considered, because it shows the fragments in detail for planning.
Treatment
Roughly four out of five of these fractures are minimally displaced and heal without surgery — a sling for comfort, then carefully guided early motion to prevent stiffness, with close X-ray follow-up.
Displaced or unstable fractures may need surgery: fixation with a plate and screws to rebuild the bone, or — in older patients with a fracture that cannot be reliably reconstructed — a reverse shoulder replacement, which reliably restores function in that setting.
Recovering from a shoulder fracture?
Learn about the treatment options and what recovery looks like.
Common questions
Most of these fractures do not — they heal well in a sling with guided motion. Surgery is reserved for displaced or unstable breaks.
Often around the first several weeks, with gentle motion starting early under guidance to keep the shoulder from stiffening.
Many people regain good function, though it takes patience and therapy. Some loss of end-range motion can occur, particularly after complex fractures.
When the ball is broken into pieces that cannot be reliably rebuilt — especially in older patients — a reverse replacement gives a more predictable, functional result than trying to fix the fragments.
This page is for general education and is not a substitute for an in-person evaluation. Your specific diagnosis and treatment plan should come from Dr. Hachadorian based on your exam and imaging.