Humerus fracture: Difference between revisions

Revision as of 08:48, 10 January 2015

Peaks in third and seventh decades of life (young men and osteoporotic elderly women)
Occurs via direct blow or FOOSH
Common site of pathologic fractures (esp breast cancer)
Rule-out radial nerve injury (wrist drop - no ext of wrist, fingers, or thumb)

Humeral anatomy

Authors:

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 ==[[Proximal humerous fracture]]==
-===Background===
-*Typically occur in elderly osteoporotic pts from FOOSH mechanism
-*Must rule-out axillary and brachial plexus neurovascular injuries
-*Greater tuberosity fx suggests rotator cuff tear
-*Lesser tuberosity fx suggests posterior shoulder dislocation
-[[File:Prox humerus fracture.jpeg|thumbnail]]
-===Clinical Features===
-*Pain, swelling, tenderness about the shoulder
-*Arm is held closely against chest wall
-===Imaging===
-*AP, lateral, and axillary radiographs
-*Fx of articular surface suggested by pseudosubluxation:
-***Superior joint hematoma pushes humerus down
-==Differential Diagnosis==
-{{Proximal arm fracture DDX}}
-===Management===
-*Guided by the Neer System
-**Proximal humerus is divided into four "parts" based on epiphyseal lines:
-***Articular surface of humeral head
-***Greater tubercle
-***Lesser tubercle
-***Shaft of humerus
-**A "one-part" fx is one in which fragment is displaced <1cm or not angulated >45deg
-*"One-part" fracture:
-**Sling and swathe, ice, ortho referral
-*More than one-part fractures:
-**Ortho consult in the ED
 ==[[Humerus shaft fracture]]==
 ===Background===