Looking after a child with a fractured proximal humerus

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 collar and cuff should be worn during the day for 2 to 3 weeks. Your child may find sleeping upright in a chair or with extra pillows more comfortable for the first few weeks.

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

Simple analgesia such as paracetamol and/or ibuprofen should be given regularly over the first few days and then as required for pain.

Hygiene and 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: the good arm out first and then the injured arm.

You can take the sling off to wash/shower as pain allows.

Your child should:

• Keep their elbow, wrists 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.

The collar & cuff should be removed after 3 weeks. The shoulder may be a little stiff due to being in the collar and cuff and may take a few days to settle down.

Please avoid rough play and contact sports for a further two weeks.