This is a basic article for medical students and other non-radiologists
Proximal humeral fractures are a heterogeneous group of fractures that include everything from relatively simple transverse fractures of the surgical neck of the humerus, to complex, displaced, multi-part fractures of the proximal humerus that extend into the shoulder joint. The shoulder is a hugely important joint and fractures of the proximal humerus can be devastating to quality of life.
On this page:
Reference article
This is a summary article. For more information, you can read a more in-depth reference article: proximal humeral fracture.
Summary
-
anatomy
- normal humerus
-
epidemiology
- predominantly older women
-
presentation
- pain and reduced range of motion of the affected shoulder
- possible distal neurovascular compromise
-
pathophysiology
- often occur secondary to direct trauma
- associated with reduced bone density (osteoporosis: older females)
- surgical neck of humerus commonly involved
- may extend to involve the joint
-
investigation
- shoulder radiograph for diagnosis
- CT for accurate assessment of complex intra-articular fractures
-
treatment
- treatment depends on fracture type, but often collar-and-cuff
- prognosis worse if it involves the joint
Radiographic features
Plain radiograph
The fracture will be demonstrated as a lucency across the proximal humerus. The cortex of the humerus may have a step, or a lesser degree of cortical irregularity. There may be some angulation at the fracture.
The fracture may extend into the joint and there may be associated dislocation.