But when the humeral head comes completely out of socket, it's virtually impossible for the acutely injured patient to reduce the dislocation themselves or with friends and medical assistance is required. This predicament can be extremely painful. Treatment of subluxations or dislocations require ice , two to three weeks immobilization, and follow-up therapy to get the shoulder back to its normal motion and strength. Patients are warned that this injury often recurs and may later require surgical invention that must address the incompetent capsule that is suppose to hold the humeral head in the socket. The patient presents with point tenderness over this area and frequently notices a bump.
Treatment is conservative with short term immobilization, ice , physical therapy and exercise .
There are very few indications for surgical intervention . In fact, multiple studies have shown that conservative and surgically treated patients with this problem one year after injury have essentially the same result. Proximal humerus fractures are usually seen in more elderly patients. Examination of the area often reveals pain, severe limitation of motion, and an unsightly black and blue area. Xrays are useful and confirm the diagnosis.