Humeral head fracture: Treatment options for a humeral head fracture: Is surgery advisable for a humeral fracture?

One fall, and suddenly everything else becomes irrelevant! This article explains why a humeral head fracture is one of the most common fractures in Germany and which treatments deliver the best results.

What are the causes of humeral head fractures?

The medical term is subcapital humeral fracture . This refers to a fracture at the upper end of the upper arm bone (humerus) —more specifically, near the ball and socket that forms the shoulder joint.

Such a shoulder fracture usually occurs as a result of a fall onto an outstretched arm . The body reflexively attempts to brace itself with the hands or arms. This forces the bone into the shoulder socket with great force, potentially breaking it.

Why does the bone at the humeral head break easily?

At the shoulder, the "anatomical neck" is distinguished at the transition from the ball to the

Bone shaft, and the "surgical neck" directly below the ball, the very place where the bone often breaks.

In this region, the outer bone layer is thin and prone to fractures.

The bony joint socket, on the other hand, is much more stable and therefore breaks less frequently.

Fractures are differentiated according to how many fracture fragments they have broken up into, since tendons of the rotator cuff attach to the individual parts.

Other evaluation criteria include the extent of bone displacement, i.e. the displacement of bone fragments, bone substance, bone density, blood flow and some other parameters.

Is osteoporosis to blame?

Shoulder fractures occur at any age.

However, fractures of the humeral head are a typical injury among older people. The average age for shoulder fractures is 67, and two-thirds of all cases are in women.

It is therefore obvious that a reduction in bone density promotes bone fractures.

However, since they also occur in young patients with very good bone quality, osteoporosis is not the sole cause of humeral fractures. Rather, it is the unfortunate moment of a fall, in which different bones can fracture depending on the force applied to the body.

What acute symptoms occur with a fracture of the oblique head?

A fracture usually causes immediate, noticeable pain , especially during movement. Other typical symptoms include:

• Severe pain in the shoulder or upper arm

• Swelling and bruising

• Restricted movement – the arm can often no longer be actively raised

• Crunching or frictional sensation when the fragments move

• Visible misalignment or “hanging” of the arm

Diagnosis of humeral fractures and shoulder joint

If you notice such symptoms after a fall, you should seek medical attention immediately . Only a thorough examination—usually including an X-ray or CT scan —can determine whether it is a fracture and its severity.

How is a humeral head fracture treated and what are the consequences of a humeral head fracture?

Treatment depends on the severity of the fracture, and the following factors play a role:

• How many pieces the bone is broken into

• Whether the fragments are displaced

• How stable the fracture is

• Patient's age, general condition and bone quality

Conservative treatment (without surgery)

Many shoulder fractures—especially simple and stable ones—can be treated without surgery . This is called conservative therapy . The arm is immobilized in a special shoulder brace (e.g., a Gilchrist brace) . Patients also receive:

• Painkillers

• Physiotherapy to promote mobility

• Check-ups with X-rays

The healing period is typically 6 to 8 weeks . It's important to carefully move the shoulder early on to avoid stiffness .

When should a humeral head fracture be operated on?

In complex fractures—for example, when the bone has broken into multiple pieces or the fragments are severely displaced— surgery is necessary . The goal is to restore the joint's original shape and function . In the hands of an experienced surgeon, the broken bone can be stabilized or shoulder function can be restored with an artificial joint.

Depending on the type of fracture, different procedures are possible:

• Stabilization, screwing or plating with metal plates and screws

• Nailing from the inside through the medullary cavity of the bone

• Artificial shoulder joint (endoprosthesis) , e.g. in cases of severe bone destruction, shoulder function is restored by a shoulder prosthesis.

Even after surgery, intensive physiotherapy is important to restore shoulder mobility. The day after surgery, targeted physiotherapy exercises are performed to improve shoulder joint mobility and movement.

What happens after a fracture of the humeral head?

Rehabilitation after a fracture is crucial for the healing process. The goal is to regain full mobility and strength of the arm.

Important measures:

• Physiotherapy for mobilization and muscle building, no long-term immobilization

• Patience and regular exercises at home

• Avoiding premature stress

Complete healing can take several months. In many cases, healing takes between 6 and 12 months. Depending on age, bone quality, and the type of fracture, it can be faster or slower.

Conclusion: Serious , but treatable

Whether caused by a fall in everyday life , osteoporosis, or a sports mishap, a humeral head fracture is a very painful, long-lasting, but easily treatable injury. It is important that the fracture is detected early and treated appropriately .

Thanks to modern medicine, individualized treatment plans, and targeted rehabilitation measures, patients today have a good chance of a complete recovery – while maintaining mobility and quality of life.

Do you have a humeral head fracture and are unsure how it should be treated?

Make an appointment now for evaluation and treatment of your shoulder fracture.