ORIF Surgery for Proximal Humerus Fracture

ORIF surgery for a proximal humerus fracture is a treatment option for displaced shoulder fractures. While many shoulder fractures can be treated optimally without surgery, some shoulder fractures have significantly separated fracture fragments and these are often best treated with surgery to realign and stabilize the bone in an anatomic position. Proximal humerus ORIF surgery (ORIF = open reduction internal fixation) is performed using a plate directly against the bone and screws inserted through the plate to hold the fracture fragments together. To determine your best treatment options, consult with a board-certified shoulder surgeon in Seattle, Dr. Sara Jurek. 

The shoulder is made of three bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula (shoulder blade).

The humerus and scapula join at the glenohumeral joint. This joint is held together by the group of tendons and muscles and tendons collectively called the rotator cuff.

A proximal humerus fracture is a fracture of the upper part of the humerus. It is a broken bone that involves the ball of the shoulder’s ball-and-socket joint.
Proximal humerus fractures typically break in certain places and into multiple pieces due to the location of the rotator cuff tendons attachment points:

• The greater tuberosity (supraspinatus, infraspinatus, and teres minor tendon attachment)
• The lesser tuberosity (subscapularis tendon attachment)
• The humeral head
• The surgical neck

If you have a proximal humerus fracture, or have injured your shoulder and suspect you may have a shoulder fracture, call Dr. Sara Jurek for a consultation:

• Severe shoulder pain
• Inability to move the arm
• Swelling and possibly bruising of the shoulder and arm
• Shoulder deformity - “it does not look right”

Many patients receive the diagnosis of a proximal humerus fracture in the Emergency Room based on x-rays and are then advised to follow up with an orthopedic surgeon within a few days.

Depending on if you were evaluated in the ER or if you are seeing Dr. Jurek for an initial evaluation of your shoulder injury, she will review your x-rays with you and may order additional x-rays if needed.

Dr. Jurek will go over your x-rays and will discuss the following during your clinic visit:

• The exact type of injury you have
• The severity of your injury
• Whether surgery will be necessary
• The treatment plan (options based upon your specific injury and your specific goals)
• The possible complications
• When it is expected that you will be maximally improved
• What the expected outcome will be both in the short term and in the long term

Treatment options for a proximal humerus fracture depend on the severity of the fracture.

Nonsurgical Treatment. If the bones have not shifted out of place, the fracture may be treated without surgery with a sling, pain medication, and physical therapy. Physical therapy starts with range of motion exercises followed by strengthening exercises once the bone begins to heal.

Follow-Up Care. During your recovery, you will see Dr. Jurek periodically for x-rays and a physical exam to make sure the fracture is healing in a good position.

Surgical Treatment. If the fracture fragments have become significantly displaced, ORIF surgery (ORIF = open reduction internal fixation) is needed to realign (that’s the “open reduction” part of ORIF) the bones and then stabilize them (that’s the “internal fixation” part of ORIF) in their aligned position.

During the procedure, an incision is made, the fracture fragments are positioned anatomically and a metal plate and screws are attached to the humerus to hold the bone in place while it heals. X-rays are taken intraoperatively to confirm the correct positioning of the fracture and hardware.
The plate and screws are not routinely removed after the bone heals unless they are causing discomfort.

After surgery, your arm will be protected in a sling, and Dr. Jurek will have you start gentle shoulder range of motion exercises a few days after surgery. Use cold therapy to help with postoperative pain and take pain medication as directed.

Recovery from ORIF surgery for a proximal humerus fracture typically takes about 2 months for the bone to heal fully and a few additional months for range of motion and strength to return. You can expect to begin physical therapy to regain shoulder range of motion within 2-4 weeks after surgery. Strengthening exercises are added gradually as your healing progresses.

If you have broken your shoulder or have injured it and are concerned that you may have a proximal humerus fracture, request an appointment online or call Dr. Sara Jurek at (206) 386-2600 to schedule an appointment.