Proximal humeral fracture

Case contributed by Frank Gaillard
Diagnosis certain


Fall while gardening 6 days ago. Unable to move arm.

Patient Data

Age: 75 years
Gender: Female

Surgical neck of humerus fracture is demonstrated with an additional fracture separating the greater tuberosity. There is only minor displacement with moderate impaction and angulation (~30 degrees), with the glenohumeral joint remaining enlocated. Degenerative change of the acromioclavicular joint is noted.

Annotated image

The three fragments to this fracture are visible on the AP view: humeral head (red), humeral shaft (blue) and greater tuberosity (yellow). These are minimally displaced and only mildly angulated. 

Case Discussion

Typical appearances of a minimally displaced proximal humeral fracture involving not only the surgical neck but also the greater tuberosity. This illustrates the importance of understanding the Neer classification. This would be considered a one-part fracture, as although both a greater tuberosity and surgical neck of humerus fracture are present neither are significantly displaced (<1cm) nor are they significantly angulated (<45 degrees).

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