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Humerus Fracture, Emergency Medicine

G. Richard Bruno Reviewed 06/2017
 


Basics

Description

  • Proximal humeral fractures:

    • Typically described as nondisplaced, displaced, and/or fracture/dislocation

    • Account for 5% of all fractures

    • Increased incidence with age

    • 4:1 female to male

    • Vas...

Diagnosis

Signs and Symptoms

  • Pain, swelling, and tenderness

  • Difficulty in initiating active motion

  • Arm often closely held against chest

  • Shortening of the extremity

  • Crepitus may be present

  • Ecchymosis

  • Neurovas...

Treatment

Pre-Hospital

Cautions: 
  • Avoid excessive movement of the arm, which may produce further neurovascular injury.

  • Immobilize with sling and swath and transport.

  • Rapid transport in the presence of neu...

Follow-Up

Disposition

Admission Criteria

  • Open fractures for operative management and parenteral antibiotic therapy

  • Fractures associated with vascular compromise

  • Displaced fractures that cannot be treated ...

Pearls and Pitfalls

  • All humeral fractures should have diligent neurovascular exams:

    • Neurovascular exam should be repeated after manipulation.

    • Radial nerve injuries are the most common deficits seen in h...

Additional Reading

  • Cavigilia  H, Garrido  CP, Palazzi  FF, et al. Pediatric fractures of the humerus. Clin Orthop Rel Res.  2005;432:49–56.

  • Green  A, Norris  TR. Proximal humerus fractures and gle...

Codes

ICD9

  • 812.01 Closed fracture of surgical neck of humerus

  • 812.02 Closed fracture of anatomical neck of humerus

  • 812.20 Closed fracture of unspecified part of humerus

  • 812.03 Closed fracture of greater t...

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