Proximal Humerus Fractures

  • Jaclyn M. Jankowski
  • Richard S. Yoon
  • Frank A. Liporace


Currently, proximal humerus fractures make up 7% of all fractures and 80% of all humerus fractures. In patients older than 65, proximal humerus fractures make up more than 10% of all fractures and are the third most common non-vertebral osteoporotic fracture following fractures of the distal radius and proximal femur. There are a variety of treatment options for proximal humerus fractures, including non-operative management, percutaneous pinning, screw osteosynthesis, plating, intramedullary nailing, and arthroplasty (hemi, total, and reverse). While many of the elderly can be treated non-operatively, those meeting operative criteria are offered our preferred management: open reduction internal fixation with a proximal humeral locking plate. We aim to outline our technique and provide a stepwise approach in order to achieve an optimal clinical result.


Proximal humerus Proximal humerus fractures Open reduction internal fixation (ORIF) Locked plating 


  1. 1.
    Streubel PN, Sanchez-Sotelo J, Steinmann SP. Proximal humerus fractures. In: Court-Brown C, Heckman JD, McQueen MM, Ricci WM, Tornetta P, editors. Rockwood and Green’s fractures in adults. Philadelphia: Wolters Kluwer Health; 2015. p. 13411425.Google Scholar
  2. 2.
    Schulte LM, Matteini LE, Neviaser RJ. Proximal periarticular locking plates in proximal humerus fractures: functional outcomes. J Shoulder Elb Surg. 2011;20:1234–40.CrossRefGoogle Scholar
  3. 3.
    Hasty EK, Jernigan EW, Soo A, Varkey DT, Kamath GV. Trends in surgical management and costs for operative treatment of proximal humerus fractures in the elderly. Healio Orthopedics. 2017;40(4):e641–7.CrossRefGoogle Scholar
  4. 4.
    Sudkamp N, et al. Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. J Bone Joint Surg Am. 2009;91:1320–8.CrossRefGoogle Scholar
  5. 5.
    Olerud P, Ahrengart L, Ponzer S, Saving J, Tidermark J. Internal fixation versus nonoperative treatment of displaced 3-part proximal humeral fractures in elderly patients: a randomized controlled trial. J Shoulder Elb Surg. 2011;20:747–55.CrossRefGoogle Scholar
  6. 6.
    Xie L, Ding F, Zhao Z, Chen Y, Xing D. Operative versus non-operative treatment in complex proximal humeral fractures: a meta-analysis of randomized controlled trials. Springerplus. 2015;4:728.CrossRefGoogle Scholar
  7. 7.
    Brunner F, et al. Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma. 2009;23:163–72.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jaclyn M. Jankowski
    • 1
  • Richard S. Yoon
    • 2
  • Frank A. Liporace
    • 2
  1. 1.Department of Orthopaedic SurgeryJersey City Medical Center – RWJ Barnabas HealthJersey CityUSA
  2. 2.Division of Orthopaedic Trauma and Adult Reconstruction, Department of Orthopaedic SurgeryJersey City Medical Center – RWJ Barnabas HealthJersey CityUSA

Personalised recommendations