- See:
Proximal Humeral Physeal Injuries
- Discussion:
-
classification of proximal humeral fractures:
-
anatomic neck fracture:
-
one part fracture
-
two part fractures
-
two part surgical neck fracture
- two part tuberosity fractures:
-
lesser tuberosity frx;
-
greater tuberosity frx;
-
three part fractures
-
four part fracture:
-
fracture dislocation:
- displacing forces:
- following frx of humerus, frx fragments may be displaced as a result of pull of muscles inserting into two parts;
- w/ frx of
surgical neck, upper frag is usually abducted and externally rotated by the muscles inserting onto greater tubercle, while lower frag is adducted
& internally rotated by internal rotators; (see
rotator cuff);
- in frx of shaft, angulation & overriding may result from muscular pull;
- fractures of the middle &
lower thirds of humeral shaft are frequently associated w/ injuries of the encircling
radial nerve;
- Radiographs:
- an
axillary view is mandatory for proximal humeral fractures, as it is the view that shows the
most angulation and displacement;
- Non Operative Treatment:
- references:
-
Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization.
-
Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus.
-
Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization.
- Operative Treatment of Proximal Humerus Fractures: 
-
lateral plating technique
- Complications:
-
Non Union of Humeral Fractures:
- Avascular Necrosis:
-
Initial post-fracture humeral head ischemia does not predict development of necrosis
-
Dislocated multiple fragment fractures of the head of the humerus. Does dislocation of the humeral head fragment signify a worse prognosis?
Job 31:22 (King James Version): Then let mine arm fall from my shoulder blade, and mine arm be broken from the bone.
