Fracture Care · Shoulder & arm
Proximal humerus fracture — Fixation (plate and screws)
Proximal Humerus Fracture (Broken Upper Arm Bone at the Shoulder) — Open Reduction and Internal Fixation (ORIF)
The condition
The proximal humerus is the top of the upper arm bone—the ball of the shoulder joint and the bony bumps (tuberosities) where the rotator cuff tendons attach. It usually breaks in a fall onto the arm or shoulder. When the pieces are badly shifted, the shoulder can heal stiff, weak, or painful.
The surgery
Through an incision at the front of the shoulder, the broken pieces are put back in place and held with a plate and screws, often with strong sutures through the rotator cuff tendons for extra hold. Some fractures are instead held with a rod (nail) inside the bone.
Recovery at a glance
- Sling
- Worn for 4 weeks (6 if the bone is fragile), off for therapy, hygiene, and exercises. Your therapist often begins gently moving the shoulder in the first week.
- Daily life
- Elbow, wrist, and hand motion right away. Desk work often within 1–2 weeks. No lifting, pushing, or leaning on the arm for 6 weeks. No driving while taking narcotic pain medication.
- Lifting & overhead
- Using the arm on its own begins at 6 weeks, with lifting up to 5 lb. Strengthening and heavier lifting progress once the bone heals (~3 months).
- Sports
- Light sports ~3-4 months; overhead and heavier sports between 4 and 6 months.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring the shape of the shoulder gives the best chance of regaining motion, strength, and function. Risks are uncommon and include infection, blood clots, shoulder stiffness, the fracture shifting or screws backing into the joint, loss of blood supply to the ball of the shoulder, hardware irritation that may require removal, injury to nearby structures (such as nerves or blood vessels), stiffness, persistent pain, and the need for further surgery. In some cases, the bone is unable to heal properly due to limited blood supply, and in these cases, the shoulder often does better with a replacement at a later date.
Patient Surgical Information
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Before & after every surgery