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Most proximal humerus fractures are stable and can be treated without surgery. [8] Typical non-operative treatment consists of shoulder immobilization with a sling. Close follow-up and weekly x-rays are recommended in order to ensure that the fracture is healing and maintaining good alignment.
One example of a commonly used regional anesthetic is an interscalene brachial plexus block and it has been used in a number of shoulder procedures including instability repairs, proximal humeral prosthetic replacements, total shoulder arthroplasties, anterior acromioplasties, rotator cuff repairs, and operative treatment of humeral fractures. [24]
Proximal fractures make up 5% of all fractures and 25% of humerus fractures, [9] middle fractures about 60% of humerus fractures (12% of all fractures), [12] and distal fractures the remainder. Among proximal fractures, 80% are one-part, 10% are two-part, and the remaining 10% are three- and four-part. [22]
This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. [1] In children, many of these fractures are non-displaced and can be treated with casting. Some are angulated or displaced and are best treated with surgery.
The arm should be abducted 80 to 100 degrees. This method reveals: [26] The horizontal alignment of the humerus head in respect to the socket and the lateral clavicle in respect to the acromion; Lesions of the anterior and posterior socket border, or of the tuberculum minus; The eventual non-closure of the acromial apophysis; The coraco-humeral ...
A fracture in this area is most likely to cause damage to the axillary nerve and posterior circumflex humeral artery. Damage to the axillary nerve affects function of the teres minor and deltoid muscles, resulting in loss of abduction of arm (from 15-90 degrees), weak flexion, extension, and rotation of shoulder as well as loss of sensation of ...
It is vulnerable to injury with fractures of the humeral shaft as it lies in very close proximity to the bone (it descends within the spiral groove on the posterior aspect of the humerus). Characteristic findings following injury will be as a result of radial nerve palsy (e.g. weakness of wrist/finger extension and sensory loss over the dorsum ...
Studies generally use the x-ray appearance of the arm to determine how displaced a fracture is. The definition of ‘displaced fractures' are variable, with anything from 2mm to more than 15mm; [4] however x-rays on which this assessment is made are known to be hugely misleading with fractures showing little displacement having >10mm displacement using CT scans.