Proximal humeral fracture (summary)
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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.
- normal humerus
- predominantly older women
- pain and reduced range of motion of the affected shoulder
- possible distal neurovascular compromise
- 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
- shoulder radiograph for diagnosis
- CT for accurate assessment of complex intra-articular fractures
- treatment depends on fracture type, but often collar-and-cuff
- prognosis worse if it involves the joint
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.