Upper Limb Fractures: Humeral neck Flashcards
are proximal humeral neck fractures common or uncommon
common
what is the typical history of a humeral neck fracture
low energy injury in osteoporotic bone due to fall on outstretched hand or directly onto shouler
what is the most common fracture pattern seen in humeral neck fractures
fracture of surgical neck with medial displacement of humeral shaft
what causes a medial displacement of the humeral shaft in a humeral neck fracture
due to the pull of the pectoralis major muscle
what does avulsed mean
a tearing away/torn off of
describe what may happen to the muscles of the rotator cuff in relation to the greater and lesser tuberosities in a humeral fracture
muscles may be avulsed from their attachments with the greater and lesser tuberosities
what muscles may be avulsed from their attachment at the greater tuberosity of the humerus in a humeral neck fracture
supraspinatus, infraspinatus, teres minor
what muscle may be avulsed from their at the lesser tuberosity of the humerus in a humeral neck fracture
subscapularis
what are some uncommon fracture patterns that can occur at the proximal humerus
isolated fracture of greater tuberosity, or head-splitting intra-articular fractures
describe how many undisplaced proximal humerus fractures are treated
conservatively with a sling and gradual return to mobilisation
with displaced fractures what occurrence helps improve the position of the humerus
when muscle spasm settles
describe how persistently displaced humeral neck fractures are treated
with internal fixation, with wires, plates, screws or intramedullary(IM) nails
what complications can occur with internal fixation of humeral neck fractures especially in older patients
stiffness, chronic pain, failure of fixation
what patterns of humeral shaft fracture can occur by falling, with or without twisting injury
oblique or spiral fractures
what patterns of humeral shaft fracture can occur by direct trauma
transverse or comminuted fractures
what nerve is susceptible to injury in humeral shaft fractures, and where is it
radial nerve, in the spiral groove
what presentation suggests loss of nerve function in a humeral shaft fracture
presents with wrist drop and loss of sensation in first dorsal web space
(radial nerve)
what are most cases of humeral shaft fracture treated with
non-operatively with humeral brace which compresses the fragments into acceptable alignments and provides some stability
what treatment is used for polytrauma and for non union humeral shaft fractures
polytrauma = IM nail
non union = plating and bone grafting
