Proximal Humerus Fracture

Aetiology

  • Common injury, typically low energy of osteoporotic bone from a fall
  • Usually a surgical neck fracture (rather than anatomical neck)
  • Ranges from simple two part fractures to multiple part fractures involving the humeral head

Clinical presentation

Symptoms

  • Pain and swelling
  • Decreased motion

Signs

  • Extensive ecchymosis of chest, arm and forearm
  • Neurovascular exam - axillary nerve injury most common

Investigations

  • X-ray - AP and lateral
  • CT if needed for pre-op planning
  • MRI rarely indicated but sometimes used to identify associated rotator cuff injury

Management

  • Conservative - collar and cuff
  • Operative - ORIF, replacement