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Besides not wanting to risk the usual risks of surgery such as infection, shoulder replacement can lead to a variety of complications including rotator cuff tear and glenohumeral instability. However, despite these risks, shoulder replacement shows promise with a low rate of complication which depending on the type of surgery is close to 5%. [20]
Types include proximal humeral fractures, humeral shaft fractures, and distal humeral fractures. [1] [2] Diagnosis is generally confirmed by X-rays. [2] A CT scan may be done in proximal fractures to gather further details. [2] Treatment options may include a sling, splint, brace, or surgery. [1]
The surgical neck of the humerus is a bony constriction at the proximal end of shaft of humerus. It is situated distal to the greater tubercle and lesser tubercle , and proximal to the deltoid tuberosity .
Extension type of supracondylar humerus fractures typically result from a fall on to an outstretched hand, usually leading to a forced hyperextension of the elbow. The olecranon acts as a fulcrum which focuses the stress on distal humerus (supracondylar area), predisposing the distal humerus to fracture. The supracondylar area undergoes ...
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 ...
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.
The mechanism of action has been described as a triple blocking effect: conjoint tendon of shoulder i.e short head of the biceps and coracobrachialis, acting as a sling on the subscapularis and capsule with the arm abducted and externally rotated;
impacted posterior humeral head fracture occurring during anterior shoulder dislocation: Hill Sachs Lesion at Wheeless' Textbook of Orthopaedics online Holstein–Lewis fracture: Arthur Holstein Gwylim Lewis: fracture of the distal third of the humerus resulting in entrapment of the radial nerve: Holstein-Lewis fracture at Orthopedic Weblinks