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Fracture, Humeral Head, Sports Medicine

Julie Chuan, MD, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

  • Caution: Excessive movement of the arm may produce further neurovascular injury.

  • Controversy: Prehospital reduction is not recommended because manipulation may lead to neurovascular compromise o...

DIAGNOSIS

Pediatric Considerations
  • In children, proximal humeral fractures consist of metaphyseal fractures and physeal separations. Three fracture patterns tend to vary depending on the age group:

    • Chil...

TREATMENT

Pediatric Considerations
  • Birth fractures heal rapidly with only 2 to 3 wk of immobilization 2[C].

  • Pediatric patients are often less compliant with immobilization and less able to verbalize com...

ONGOING CARE

The proximal humerus is supplied by the axillary artery, which is often disrupted with displaced fractures resulting in avascular necrosis of the humeral head. 

PROGNOSIS

  • About 90% are trea...

REFERENCES

1
Tsuda T. Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature. Curr Orthop Pract.  2017;28(6):580–585.
2
Popkin CA, Levine WN, A...

ADDITIONAL READING

  • Hawkins RJ, Angelo RL. Displaced proximal humeral fractures. Selecting treatment, avoiding pitfalls. Orthop Clin North Am.  1987;18(3):421–431.

  • Neer CSII. Displaced proximal hum...

CLINICAL PEARLS

  • Axillary artery is the most common neurovascular injury and can result in avascular necrosis of the humeral head.

  • When evaluating shoulder dislocations, consider associated humeral head...

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