Presentation
Trauma - pedestrian vs car
Patient Data
CT CHEST (WITH ANGIOGRAPHY)
FINDINGS: Significantly displaced fracture-dislocation of the proximal humerus with the fractured humeral head displaced into the right axilla by a distance of approximately 50 mm. The head lies adjacent to the slightly distorted axillary artery in which there is a small dissection flap. No vascular occlusion.
The aorta is of normal caliber. No dissection seen. A smooth bulge along the undersurface of the thoracic aortic arch likely represents a ductus diverticulum. Lateral to this is partially calcified atherosclerotic disease and mural irregularity. In the absence of significant mediastinal hematoma, this most likely represents ulcerated atherosclerotic disease The lung fields are clear, apart from mild atelectasis at the bases. No pneumothorax. No rib or vertebral fracture seen.
X-ray right shoulder
There is a fracture dislocation through the surgical neck of humerus and proximal shaft.
The humeral head is dislocated inferoanteriorly and the distal humeral shaft is impacted upon the glenoid.
Multiple displaced butterfly fragments are seen inferior to the glenoid fossa.
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