Humeral Neck Fractures

Question 1

Usual cause?

Answer 1

Fall onto outstretched hand /directly onto shoulder

Question 2

What is the most common humeral neck fracture?

Answer 2

Fracture of surgical neck

Question 3

What can also occur with humeral fracture of neck?

Answer 3

+ medial displacement of humeral shaft (pull of pectoralis major)

+/- greater and lesser tuberosities may be avulsed with muscle attachments

Question 4

Treatment of displaced humeral neck fracture?

Answer 4

Position often improves once muscle spasm settles

Question 5

Treatment of minimally displaced humeral neck fracture?

Answer 5

Conservative

Sling and gradual return to mobilization

Question 6

Treatment of persistently displaced humeral neck fracture?

Answer 6

Internal fixation

-Plate, screws, wires, intramedullary nail

Question 7

Treatment of 3/4 part comminuted fracture?

Answer 7

Difficult and controversial:

• Humeral head can undegro AN- chronic pain
• Shoulder replacement: hemiarthroplasty

Question 8

Head splitting fracture treatment?

Answer 8

Shoulder replacement (unless young)