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Forum Name: Bone trauma and fractures

Question: fractured proximal humerus, mri findings and treatment


 barbara1b - Wed May 27, 2009 10:00 am

Dec. 2008 I fell off a ladder and fractured my proximal humerus while visiting in
Georgia. The doctor there told me I would need surgery and set me up with a
wonderful sling, compression sleeve and pain killers.
I saw a New York doctor immediately upon arriving home and was told that therapy would be best for me.
Now I have completed 4 months of therapy and still have pain and difficulty with certain movements.
MRI findings are....Deformity of proximal humerus at level of the surgical neck with linear marrow signal changes corresponding to prior fracture deformity. Posterior rotation of the humeral head with a fracture fragment involving the posterior aspect of the greater tuberosity.....small full thickness tear anteriorly near the distal supraspinatus tendon attachment. Fluid extends into the subacromial/subdeltoid bursa. High grade partial thickness articular surface tearing involving the anterior fibers of the infraspinatus tendon.
My doctor has told me to have a cortizone shot. Does that seem appropriate?
He does not think surgery or more therapy will help.
Do I need a second opinion? I will suck it up if I have to but am disabled to some
extent.
I have gotten opinions from 3 therapists and a nurse (friends and family)
all saying if it was their shoulder, they would get a second opinion and probably surgery.
I would appreciate your input to help me make a good decision.
Thank you so much.
Barbara
 Tom Plamondon PA-C - Wed Jun 10, 2009 8:25 pm

User avatar Hello Barbara,
There is enough structural damage, lasting pain and dysfunction to warrant a second opinion from an orthopedic surgeon.

It sounds like the rotator cuff was torn from its insertion on the greater tuberosity. This may be fixable with surgery. There will be no guarantees for restoration of full use but with 4 months of therapy and no improvement, surgery may be a good option.

Take care.

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