Paediatric proximal humerus fracture

This page aims to answer some of the questions that you or your child may have about managing a humerus fracture.

What is a proximal humerus fracture?

A proximal humerus fracture is a fracture of the upper arm bone, which forms the shoulder joint with the shoulder blade. It is a fairly common break in children, and can be caused by falling onto the arm or shoulder. These fractures usually heal well with simple advice and instructions.

Treatment and advice

What is the treatment?

Most patients with this type of fracture do not require surgery; the break can normally be managed without surgery.

The best way to treat the initial pain and discomfort is to place the injured arm in a ‘collar and cuff’ foam sling that allows the bruising and bone time to heal. The sling should be worn during the day for three to four weeks.

Swelling and bruising at the fracture site is normal. There may also be a bump at the fracture site, but as the bone heals, this will become non tender and settle.

Simple over-the-counter painkillers will help to reduce swelling and pain. Your child may find sleeping upright in a chair or with extra pillows more comfortable for the first few weeks.

Hygiene/ clothing

Your child will find it easier to get dressed by putting their injured arm into the sling first, and then putting it over the head. To remove clothing, simply reverse: good arm out first and then the injured arm.

Your child should:

• Keep their elbow, wrist and fingers moving to prevent stiffness.
• Use their hand to feed themselves and wash their face as the pain allows.
• Use the collar and cuff to hold their arm in a comfortable position.

Your child should not:

• Put pillows under their elbow.
• Play any sports or take part in PE until advised by the fracture clinic.
• Lift anything heavier than a cup of drink for six weeks.
• Miss any arranged appointments with the fracture clinic.

Physiotherapy is not usually required, but this will be assessed by the clinician in the fracture clinic.

Please remember:

• Contact your GP if your child’s condition is not improving, or if their pain relief is not adequate.
• If your child’s condition is worsening (increased pain, swelling, pins and needles or numbness) call the Multi-Professional Fracture Clinic on 01223 348299 or 01223 257095
• For more information, visit the Fracture Info website (opens in a new tab).
• For any concerns on wounds email the fracture information team – include your hospital number and any photos of your wounds that you would like to be reviewed.