Document neuro/vascular Exam findings Carefully for all humeral fractures Neck Fall onto limb –usually elderly pt Displacement may be severe without functional compromise Axillary nerve injury – may recover with time Collar & cuff. Hanging U-slab if displaced. Fracture clinic for most. Immediate referral to ortho for young, active patients on day of injury Greater tuberosity Fall onto shoulder or outstretched arm Displacement may lead to cuff dysfunction stiffness or impingement Collar and cuff. Avoid active elevation/abduction Fracture clinic Shaft – usually mid third Indirect twisting force causes spiral # Direct blow –transverse # Rare in children – consider NAI Proximal half is common site for pathological # Radial nerve injury – wrist drop. Recovery usually spontaneous if closed Occasionally require internal fixation. Hanging U slab may be useful for analgesia Fracture clinic unless radial nerve injury in which case, discuss with Orth team Supracondylar Common in children. Fall on outstretched arm Significant arterial and nerve injury common. Requires careful assessment Undisplaced – POP with elbow at 90o. Displaced or significant angulation– POP and refer for MUA Fracture clinic if MUA not required and no extreme swelling. Most heal well within 3 weeks Lateral epicondyle Rare. Mostly children. Caused by a fall May require fixation if displaced As above As above Medial epicondyle Usually children –avulsed by flexor muscles during a fall, dislocation or subluxation of the elbow Ulnar nerve injury As for supracondylar injuries As for supracondylar injuries Humeral fractures and injuries
INJURY SITE TYPICAL MECHANISM PITFALLS/COMPLICATIONS ED/ MIU/ UCC TREATMENT FOLLOW-UP
MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd |
Humeral fractures and injuries
-
| About | Anaesthetics and Critical Care | Anatomy | Basic Science | Biochemistry | Cardiology | Cases | Clinical Cases | Crib | Dentistry | Dermatology | Differentials | Drugs | ENT | Electrocardiogram | Embryology | Emergency Medicine | Endocrinology | Ethics | Foundation Doctors | Gastroenterology | General Information | General Practice | Genetics | Geriatric Medicine | Guidelines | Haematology | Hepatology | Immunology | Infectious Disease | Infectious Diseases | Infographic | Investigations | Lists | Microbiology | Miscellaneous | Nephrology | Neuroanatomy | Neurology | Nutrition | OSCE | Obstetrics Gynaecology | Oncology | Ophthalmology | Oral Medicine | Paediatrics | Palliative | Pathology | Pharmacology | Physiology | Procedures | Psychiatry | Radiology | Research | Respiratory | Resuscitation | Rheumatology | Statistics | Stroke | Surgery | Surgical | Toxicology | Trauma and Orthopaedics | Twitter | Urology | Version Jan 2023