What is the appropriate management for a proximal humeral fracture?

For a proximal humeral fracture, the recommended management typically involves using a broad arm sling for immobilization. This approach helps support the affected arm while allowing for some mobility and comfort, reducing the risk of stiffness and complications associated with prolonged immobilization. Following up with X-rays is essential for monitoring the healing process and ensuring appropriate alignment, particularly in cases where there is concern for displacement of the fracture fragments.

While cast immobilization may be appropriate for other types of fractures, it is not the standard approach for proximal humeral fractures since this area requires some degree of movement to prevent stiffness and to allow the shoulder to function well post-recovery. Immediate physical therapy may not be beneficial right after the injury; instead, patients often start therapy after a short period of immobilization, focusing on range of motion and strength exercises when it's safe to do so. Surgery is reserved for specific cases, such as significantly displaced fractures or those involving the rotator cuff, rather than being the go-to approach for all proximal humeral fractures.