If there are neurological or vascular deficits, orthopaedic referral is required.Assess for brachial plexus injury through distal neurological examination. Perform a neurological examination, particularly examining the axillary nerve by testing for sensation in the regimental badge area over the deltoid muscle and assessing upper limb muscle power.Assess for associated injuries to the arm/shoulder/chest wall/lungs.Establish whether osteoporosis is likely. Additional injuries to the shoulder girdle may also be present, such as scapular fractures causing a 'floating shoulder'. Proximal humerus fractures may either occur in isolation or be associated with concurrent dislocation of the glenohumeral joint. Pain, loss of shoulder/arm function, swelling and bruising.Humeral epiphysis separation can occur in adolescents. In younger age groups, trauma is likely to be of higher energy and the resulting injury more serious. In younger people, the same injury mechanism can cause fracture with co-existing shoulder dislocation.Middle age/elderly are most commonly affected.Can also occur during seizures or electric shock when fracture may be associated with a posterior shoulder dislocation.Usually after a fall on to an outstretched hand from standing height.Proximal humerus fractures often occur in older patients after a low-energy fall. Distal humeral fractures are discussed in the separate Elbow Injuries and Fractures article. Fractures of the distal humerus in the adult account for approximately one third of all humeral fractures. One method is to classify them as:įracture of the supracondylar (distal) humerus is one of the most common fractures encountered in children. ![]() In the elderly, pathological fracture should be considered.Ĭlassification of humeral fractures is difficult. In children the possibility of non-accidental injury should be borne in mind when taking the history and examining the child, especially in very young children. Mechanism of injuryįractures of the humerus usually result from falls or direct trauma. The medial and lateral epicondyles are at the lower end of the humerus, and the joint surface consists of the capitulum (articulates with the head of the radius) and the trochlea (articulates with the ulna). The radial nerve runs posteriorly around the middle third of the humeral shaft in the spiral groove. The long head of biceps runs between the tuberosities in the bicipital groove, and the surgical neck is just below the greater and lesser tuberosities. The anatomical neck separates the greater and lesser tuberosities from the humeral head. The humeral head articulates with the glenoid fossa of the scapula. BDB, Public domain, via Wikimedia Commonsīy BDB, Public domain, via Wikimedia Commons
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |