Proximal humerus fracture: Difference between revisions
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[[ | {{SI}} | ||
{{Infobox medical condition | |||
| name = Proximal humerus fracture | |||
| image = [[File:ProxHumeralFracture.png|250px]] | |||
| caption = X-ray of a proximal humerus fracture | |||
| field = [[Orthopedic surgery]] | |||
| synonyms = Fracture of the proximal humerus | |||
| symptoms = [[Shoulder pain]], [[swelling]], [[bruising]], [[limited range of motion]] | |||
| complications = [[Avascular necrosis]], [[nerve injury]], [[shoulder stiffness]] | |||
| onset = Sudden | |||
| duration = Varies | |||
| causes = [[Trauma]], [[osteoporosis]] | |||
| risks = [[Elderly]], [[osteoporotic bone]], [[falls]] | |||
| diagnosis = [[Physical examination]], [[X-ray]], [[CT scan]] | |||
| differential = [[Shoulder dislocation]], [[rotator cuff tear]] | |||
| treatment = [[Immobilization]], [[physical therapy]], [[surgery]] | |||
| prognosis = Generally good with appropriate treatment | |||
| frequency = Common in the elderly | |||
}} | |||
A '''proximal humerus fracture''' is a type of [[bone fracture]] that occurs in the upper part of the [[humerus]], which is the long bone in the upper arm. This type of fracture is common, especially among the elderly, and can result from a fall or direct blow to the shoulder. | A '''proximal humerus fracture''' is a type of [[bone fracture]] that occurs in the upper part of the [[humerus]], which is the long bone in the upper arm. This type of fracture is common, especially among the elderly, and can result from a fall or direct blow to the shoulder. | ||
==Anatomy== | ==Anatomy== | ||
The [[humerus]] is divided into three parts: the [[proximal humerus]], the shaft, and the distal humerus. The proximal humerus includes the [[humeral head]], the [[greater tubercle]], the [[lesser tubercle]], and the [[surgical neck]]. The [[glenohumeral joint]] is formed by the articulation of the humeral head with the [[glenoid cavity]] of the [[scapula]]. | The [[humerus]] is divided into three parts: the [[proximal humerus]], the shaft, and the distal humerus. The proximal humerus includes the [[humeral head]], the [[greater tubercle]], the [[lesser tubercle]], and the [[surgical neck]]. The [[glenohumeral joint]] is formed by the articulation of the humeral head with the [[glenoid cavity]] of the [[scapula]]. | ||
==Classification== | ==Classification== | ||
Proximal humerus fractures are classified based on the location and number of fracture fragments. The most commonly used classification system is the [[Neer classification]], which categorizes fractures into four parts: | Proximal humerus fractures are classified based on the location and number of fracture fragments. The most commonly used classification system is the [[Neer classification]], which categorizes fractures into four parts: | ||
| Line 12: | Line 27: | ||
* Three-part fracture: Displacement of two fragments. | * Three-part fracture: Displacement of two fragments. | ||
* Four-part fracture: Displacement of three or more fragments. | * Four-part fracture: Displacement of three or more fragments. | ||
==Causes== | ==Causes== | ||
The primary causes of proximal humerus fractures include: | The primary causes of proximal humerus fractures include: | ||
| Line 18: | Line 32: | ||
* [[Trauma]]: Such as motor vehicle accidents or sports injuries. | * [[Trauma]]: Such as motor vehicle accidents or sports injuries. | ||
* [[Pathological fractures]]: Resulting from underlying conditions like [[bone cancer]] or [[osteoporosis]]. | * [[Pathological fractures]]: Resulting from underlying conditions like [[bone cancer]] or [[osteoporosis]]. | ||
==Symptoms== | ==Symptoms== | ||
Symptoms of a proximal humerus fracture may include: | Symptoms of a proximal humerus fracture may include: | ||
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* Limited range of motion in the shoulder. | * Limited range of motion in the shoulder. | ||
* Visible deformity in severe cases. | * Visible deformity in severe cases. | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis typically involves: | Diagnosis typically involves: | ||
* [[Physical examination]]: Assessing pain, swelling, and range of motion. | * [[Physical examination]]: Assessing pain, swelling, and range of motion. | ||
* [[Imaging studies]]: [[X-rays]] are the primary imaging modality used to confirm the fracture. [[CT scans]] or [[MRI]] may be used for more detailed evaluation. | * [[Imaging studies]]: [[X-rays]] are the primary imaging modality used to confirm the fracture. [[CT scans]] or [[MRI]] may be used for more detailed evaluation. | ||
==Treatment== | ==Treatment== | ||
Treatment options depend on the severity and type of fracture: | Treatment options depend on the severity and type of fracture: | ||
* [[Non-surgical treatment]]: Includes immobilization with a sling or brace, followed by physical therapy. | * [[Non-surgical treatment]]: Includes immobilization with a sling or brace, followed by physical therapy. | ||
* [[Surgical treatment]]: May be necessary for displaced fractures and can involve procedures such as [[open reduction and internal fixation]] (ORIF), [[hemiarthroplasty]], or [[total shoulder arthroplasty]]. | * [[Surgical treatment]]: May be necessary for displaced fractures and can involve procedures such as [[open reduction and internal fixation]] (ORIF), [[hemiarthroplasty]], or [[total shoulder arthroplasty]]. | ||
==Rehabilitation== | ==Rehabilitation== | ||
Rehabilitation is crucial for recovery and typically involves: | Rehabilitation is crucial for recovery and typically involves: | ||
* [[Physical therapy]]: To restore range of motion and strength. | * [[Physical therapy]]: To restore range of motion and strength. | ||
* [[Occupational therapy]]: To assist with daily activities and improve functional use of the arm. | * [[Occupational therapy]]: To assist with daily activities and improve functional use of the arm. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for proximal humerus fractures varies based on factors such as age, overall health, and the severity of the fracture. Most patients recover well with appropriate treatment and rehabilitation, although some may experience long-term complications such as [[shoulder stiffness]] or [[arthritis]]. | The prognosis for proximal humerus fractures varies based on factors such as age, overall health, and the severity of the fracture. Most patients recover well with appropriate treatment and rehabilitation, although some may experience long-term complications such as [[shoulder stiffness]] or [[arthritis]]. | ||
==Complications== | ==Complications== | ||
Potential complications include: | Potential complications include: | ||
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* [[Avascular necrosis]] of the humeral head. | * [[Avascular necrosis]] of the humeral head. | ||
* [[Nerve injury]], particularly to the [[axillary nerve]]. | * [[Nerve injury]], particularly to the [[axillary nerve]]. | ||
==Prevention== | ==Prevention== | ||
Preventive measures include: | Preventive measures include: | ||
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* Use of protective gear during high-risk activities. | * Use of protective gear during high-risk activities. | ||
* Management of underlying conditions like osteoporosis. | * Management of underlying conditions like osteoporosis. | ||
==See also== | ==See also== | ||
* [[Humerus]] | * [[Humerus]] | ||
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* [[Orthopedic surgery]] | * [[Orthopedic surgery]] | ||
* [[Shoulder joint]] | * [[Shoulder joint]] | ||
==References== | ==References== | ||
{{Reflist}} | {{Reflist}} | ||
==External links== | ==External links== | ||
[[Category:Orthopedic surgery]] | [[Category:Orthopedic surgery]] | ||
[[Category:Bone fractures]] | [[Category:Bone fractures]] | ||
[[Category:Shoulder]] | [[Category:Shoulder]] | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
{{Orthopedic-surgery-stub}} | {{Orthopedic-surgery-stub}} | ||
Latest revision as of 06:05, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Proximal humerus fracture | |
|---|---|
| File:ProxHumeralFracture.png | |
| Synonyms | Fracture of the proximal humerus |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Shoulder pain, swelling, bruising, limited range of motion |
| Complications | Avascular necrosis, nerve injury, shoulder stiffness |
| Onset | Sudden |
| Duration | Varies |
| Types | N/A |
| Causes | Trauma, osteoporosis |
| Risks | Elderly, osteoporotic bone, falls |
| Diagnosis | Physical examination, X-ray, CT scan |
| Differential diagnosis | Shoulder dislocation, rotator cuff tear |
| Prevention | N/A |
| Treatment | Immobilization, physical therapy, surgery |
| Medication | N/A |
| Prognosis | Generally good with appropriate treatment |
| Frequency | Common in the elderly |
| Deaths | N/A |
A proximal humerus fracture is a type of bone fracture that occurs in the upper part of the humerus, which is the long bone in the upper arm. This type of fracture is common, especially among the elderly, and can result from a fall or direct blow to the shoulder.
Anatomy[edit]
The humerus is divided into three parts: the proximal humerus, the shaft, and the distal humerus. The proximal humerus includes the humeral head, the greater tubercle, the lesser tubercle, and the surgical neck. The glenohumeral joint is formed by the articulation of the humeral head with the glenoid cavity of the scapula.
Classification[edit]
Proximal humerus fractures are classified based on the location and number of fracture fragments. The most commonly used classification system is the Neer classification, which categorizes fractures into four parts:
- One-part fracture: No significant displacement.
- Two-part fracture: Displacement of one fragment.
- Three-part fracture: Displacement of two fragments.
- Four-part fracture: Displacement of three or more fragments.
Causes[edit]
The primary causes of proximal humerus fractures include:
- Falls: Especially common in the elderly due to osteoporosis.
- Trauma: Such as motor vehicle accidents or sports injuries.
- Pathological fractures: Resulting from underlying conditions like bone cancer or osteoporosis.
Symptoms[edit]
Symptoms of a proximal humerus fracture may include:
- Severe shoulder pain.
- Swelling and bruising around the shoulder.
- Limited range of motion in the shoulder.
- Visible deformity in severe cases.
Diagnosis[edit]
Diagnosis typically involves:
- Physical examination: Assessing pain, swelling, and range of motion.
- Imaging studies: X-rays are the primary imaging modality used to confirm the fracture. CT scans or MRI may be used for more detailed evaluation.
Treatment[edit]
Treatment options depend on the severity and type of fracture:
- Non-surgical treatment: Includes immobilization with a sling or brace, followed by physical therapy.
- Surgical treatment: May be necessary for displaced fractures and can involve procedures such as open reduction and internal fixation (ORIF), hemiarthroplasty, or total shoulder arthroplasty.
Rehabilitation[edit]
Rehabilitation is crucial for recovery and typically involves:
- Physical therapy: To restore range of motion and strength.
- Occupational therapy: To assist with daily activities and improve functional use of the arm.
Prognosis[edit]
The prognosis for proximal humerus fractures varies based on factors such as age, overall health, and the severity of the fracture. Most patients recover well with appropriate treatment and rehabilitation, although some may experience long-term complications such as shoulder stiffness or arthritis.
Complications[edit]
Potential complications include:
- Nonunion or malunion of the fracture.
- Avascular necrosis of the humeral head.
- Nerve injury, particularly to the axillary nerve.
Prevention[edit]
Preventive measures include:
- Fall prevention strategies for the elderly.
- Use of protective gear during high-risk activities.
- Management of underlying conditions like osteoporosis.
See also[edit]
References[edit]
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