Fractures of the proximal humerus: overview and non-surgical management

Abstract Proximal humeral fractures account for 6% of all adult fractures, usually occurring in elderly patients following a low-energy fall. Fracture patterns occur because of the intricate bony anatomy of the proximal humerus and its rotator cuff attachments, which cause displacement of the tuberosities in a predictable nature. This can lead to long-term functional deficit, not only due to mechanical restrictions but also biological consequences such as impaired vascularity and avascular necrosis. The majority of fractures can be treated non-operatively to give satisfactory restoration of function for the vast majority of patients, with recent literature evidence supporting this method of management.