Key words: fracture, proximal humerus, conservative, osteoporosis. Ability to restore stability of the fracture with anatomic restoration in surgically treated fractures Proximal humerus fractures - Part 1: Conservative management.Willingness of the patient to undergo lengthy rehabilitation.The overall prognosis from proximal humerus fractures depends on numerous factors, including the following:
The personality of the fracture (eg, bone quality, fracture orientation, concurrent soft tissue injuries), the personality of the patient (eg, compliant, realistic expectations, mental status), and the personality of the surgeon (eg, surgical experience, technical familiarity, available resources) all have a tremendous effect on specific treatment indications.īelow are two examples of displaced fractures that require surgical fixation: The decision for surgery and the surgical methods require a skilled and experienced surgeon and a motivated patient. The fracture pattern can be complex and difficult to assess adequately with plain x-rays, so a CT scan may be required to better understand the severity of the fracture. The parts that most commonly produce these fragments are the humeral head, the greater and lesser tuberosities, and the surgical neck. The most common definition of displacement is 1 cm between fragments or 45° of angulation between fracture fragments. A humerus fracture, which is a complete or partial breakage of the upper arm bone, is most commonly caused by trauma, particularly a fall, and accounts for 3 percent of all fractures. A supportive sling followed by early rehabilitation and have good functional outcomes.ĭisplaced fractures require reconstuction, because if left untreated will have a high likelihood of producing limited function. 2.1 Shoulder and Upper Arm Diagnoses 3 Management & Disposition. Most fractures are minimally displaced and stable, so surgical fixation is not required. Fractures of the humerus are classified in one of two ways: proximal humerus fracture or humerus shaft fracture. 1.1 Humerus Fractures 2 Differential Diagnosis.
The treatment objective in proximal humerus fractures is to allow bone and soft tissue healing in a normal anatomical position to maximise function of the upper extremity. In younger patients, high-energy trauma is the cause of injury. The most common mechanism for these fractures is a fall on the outstretched hand from a standing height. These fractures tend to occur in older patients who are osteoporotic. Fractures of the proximal humerus are common, accounting for 5% of all fractures.
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