Fracture Dislocations of the Shoulder

- See:
        - Anterior Dislocation of the Shoulder
        - Posterior Shoulder Dislocation
        - Proximal Humeral Fracture
        - Three Part Fracture Dislocation

- Discussion:
    - frx dislocations may be considered an extension of two,  three, and four part frx classifictions;
    - ultimate prognosis depends on the appearance of AVN and nonunion;
    - presence of atleast one intact tuberosity usually ensures enough blood supply to prevent AVN;
    - exam considerations:
          - note high prevelence of axillary nerve palsy, which may manifest as an postoperative pseudoparalysis with inferior subluxation;

- Two Part Fracture Dislocation:
    - 2 part anterior frx dislocation is associated w/ an avulsed greater tuberosity, or can occur thru the surgical neck;
    - in older pts w/ anterior humeral head dislocations, massive cuff tears are more common than avulsions;
    - satisfactory reductions w/ or w/o GEA is often acheived;
    - in almost all cases, closed reductions w/ no surgical rx is indicated;
    - in rare cases, long head of the biceps tendon may block reduction, necessitating ORIF;

- Three Part Fracture Dislocations:
    - shoulder replacement

Acute prosthetic replacement for severe fractures of the proximal humerus.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Saturday, June 23, 2012 6:13 pm