Proximal Humerus Fracture Treatment: Plate & Screws or Reverse Arthroplasty?

Upper-end (proximal) humerus fractures aren’t one-size-fits-all. The right operation depends on the fracture pattern, bone quality, the status of the rotator cuff, dominant arm and daily goals. Our aim is rapid pain relief and a safe return to function with minimal trade-offs.

How do we choose?

We assess tuberosity repairability, medial calcar support, any head-split component, vascularity, age/osteoporosis, cuff integrity and rehab adherence—then decide together.

When plate-and-screw fixation (ORIF) makes sense

Best fit: 2- and selected 3-part fractures with repairable tuberosities and acceptable bone. Pros: bone-preserving, excellent motion with anatomic reduction. Limits: osteoporotic hold, risk of screw cut-out/AVN/stiffness; rehab proceeds cautiously to protect union.

When reverse shoulder arthroplasty (RTSA) is the better call

Best fit: complex 3–4-part or head-split fractures, severe comminution, doubtful cuff function. Pros: fast pain relief and predictable elevation; early function often easier. Trade-offs: implant-specific risks and cost. Tuberosity reconstruction improves external rotation.

Rehabilitation & expectations

After ORIF: protected passive → progressive active → strengthening, paced by fracture union.

After RTSA: earlier functional use with clear early protection rules. In both pathways, physiotherapy + home exercises + wound care drive outcomes.

Our take—personalised planning

There isn’t one universal “best” operation; there is a best match for you. We align technique with fracture biology and your goals, then map a stepwise recovery.