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PROXIMAL HUMERUS FRACTURES
Fractures of the proximal humerus result from direct or indirect
trauma and are classified by the anatomical region injured:
| :: |
Greater
tuberosity (Figure 18.10) |
|
| :: |
Surgical
neck (Figure 18.11) |
|
| :: |
Anatomic
neck |
| :: |
Humeral
head. |
Evaluation
Suspect the diagnosis from the history and the physical findings
of pain, swelling and loss of motion of the shoulder joint.
You will need X-rays to confirm the type of fracture and to
direct treatment.
Treatment
| :: |
Immobilize
non-displaced fractures in a sling and swath.
Begin mobilization of the shoulder joint within
a few days. |
| :: |
Treat
displaced fractures and fracture dislocations
by closed manipulation under anaesthesia. If
the reduction is not acceptable, consider surgical
treatment. |
| :: |
Begin
motion as soon as the patient can tolerate
hanging arm exercises (Figure
18.3). Begin
active motion against gravity or with weights
when the fracture has healed. This is usually
at 6-–8 weeks. |
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 |
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 |
The
anatomical location of the fracture defines the treatment
|
 |
|
X-rays
are needed to evaluate the injury
|
|
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Treat
displaced fractures with closed manipulation
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The
major complication is shoulder stiffness.
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