Proximal humerus fractures - Part 1: Conservative management

Keywords fracture, proximal humerus, conservative, osteoporosis


Fractures of the proximal humerus are common, especially in osteoporotic females. Despite this, there remains significant debate around their preferred treatment. The difficulties when considering treatment options is the wide array of fracture patterns and multiple patient factors which play an important role in the outcome of the management of these fractures. Fortunately, the vast majority of these fractures can be treated conservatively. The challenge, however, is the 15% of patients in which surgery may be required such as displaced three- and four-part fractures, and fractures in young and active patients. Although various recent studies and review papers show acceptable results with conservative treatment, especially in elderly patients, the decision on when to operate and when to consider conservative treatment remains challenging. The goal of this current concepts paper is to highlight important aspects of the conservative management of patients with proximal humerus fractures, from initial assessment through to treatment, including possible complications.

Level of evidence: Level 5

Author Biographies

C Anley, Stellenbosch Universiteit

MBChB(Stell), FCS(SA)Orth, MMed (Ortho)(Stell); Consultant, Shoulder and Elbow Unit, Tygerberg Hospital, Division of Orthopaedics, Stellenbosch University

B C Vrettos, University of Cape Town

MBChB(Zim), FRCS(Eng), FCS(SA)Orth, MMed(Orth)(UCT); Associate Professor and Honorary Consultant, Shoulder and Elbow Unit, Groote Schuur Hospital, Division of Orthopaedics, University of Cape Town; Vincent Pallotti Hospital

P Rachuene, University of Cape Town

MBChB(UL-Medunsa), FCS(SA)Orth, MMed Ortho (SMU); Fellow, Shoulder and Elbow Unit, Groote Schuur Hospital, Division of Orthopaedics, University of Cape Town

S J L Roche, University of Cape Town

MBChB(UCT), FCS(SA)Orth; Associate Professor, Shoulder and Elbow Unit, Groote Schuur Hospital, Orthopaedic Research Unit and Orthopaedic Biomechanics Laboratory, Division of Orthopaedics, University of Cape Town

How to Cite
ANLEY, C et al. Proximal humerus fractures - Part 1: Conservative management. South African Orthopaedic Journal, [S.l.], v. 18, n. 3, p. 63-71, july 2019. ISSN 2309-8309. Available at: <>. Date accessed: 06 july 2020.
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