Humeral fractures fractures in in adults adults Fracture Help for Adults proximal third fractures distal third fractures midshaft fractures pathological fractures peri-prosthetic fractures neck of humerus fractures (simple) neck of humerus fractures (complex) Holstein-Lewis and wrist drop supracondylar fractures
Humeral neck neck fracture fracture neck of humerus (NOH) fracture types comprise either 2, 3 or 4 parts: 1 head of humerus 2 shaft of humerus 3 greater tuberosity 4 lesser tuberosity
Neck of of humerus humerus fractures fractures Adults with a simple neck of humerus (NOH) fracture and normal axillary nerve function can usually be discharged from the ER with: analgesia (Codeine) collar and cuff sling (single) fracture clinic appointment may need operation (ORIF with plate)
Neck of of humerus humerus fracture fracture (complex) (complex) multi-fragmentary fracture with intra-articular split of humeral head axillary nerve is at risk
Neck of of humerus humerus fractures fractures (complex) (complex) Adults with a fracture of the proximal ⅓ of their humerus need to be admitted from the ER for: analgesia (iv Acetaminophen or Morphine) collar and cuff sling (single) keep NBM (for ORIF with plate) operation on trauma list
Greater tuberosity tuberosity fracture fracture avulsion fracture of rotator cuff attachment to greater tuberosity
Greater tuberosity tuberosity fractures fractures Adults with an isolated greater tuberosity fracture of the head of their humerus can be discharged from the ER with: analgesia (Codeine) Polysling fracture clinic appointment may need operation (suture repair)
Proximal third third fractures fractures of of humeral humeral shaft shaft extra-articular intra-articular deltoid muscle abducts shaft (painful) and causes malunion deltoid muscle elevates shaft and causes malunion
Proximal third third fractures fractures of of humeral humeral shaft shaft Adults with a fracture of the proximal shaft of their humerus (and no obvious radial nerve damage) can usually be discharged from the ER with: analgesia (Codeine) collar and cuff sling (single) fracture clinic appointment may need operation (plate or IM nail/rod)
Humeral midshaft midshaft fracture fracture transverse midshaft fracture
Humeral midshaft midshaft fractures fractures Adults with a fracture of the midshaft of their humerus (and no obvious radial nerve damage) can usually be discharged from the ER with: analgesia (Codeine) collar and cuff sling (single) fracture clinic appointment may need operation (plate or IM nail/rod)
Pathological fracture fracture of of humeral humeral shaft shaft fractures through metastases rarely heal myeloma deposit
Pathological fractures fractures of humerus of humerus Adults with a pathologic fracture of their humerus should be admitted from the ER for: analgesia (iv Acetaminophen ± Morphine) collar and cuff sling (single) oncology investigations (bone scan) keep NBM (for plate or IM nail/rod) operation on trauma list
Peri-prosthetic fracture fracture of of humeral humeral shaft shaft fracture through tip of shoulder replacement
Peri-prosthetic fractures fractures of of humerus humerus Adults with a peri-prosthetic fracture of their humerus should be admitted from the ER for: analgesia (iv Acetaminophen ± Morphine) collar and cuff sling (single) keep NBM (for ORIF with locking plate) operation on trauma list in the OR
Distal third fracture fracture of of humeral humeral shaft shaft radial nerve is at risk of injury (wrist drop) with this arm-wrestler s spiral fracture
Distal third fractures fractures of of humeral humeral shaft shaft Adults with a distal shaft fracture of their humerus and normal radial nerve function can usually be discharged from the ER with: analgesia (Codeine) collar and cuff sling fracture clinic appointment may need operation (ORIF with plates)
Humeral shaft shaft fracture fracture and and wrist wrist drop drop radial nerve is at risk (wrist drop) with this fracture Holstein-Lewis injury radial nerve is fixed to proximal shaft by the intermuscular septum
Humeral shaft shaft fracture fracture and and wrist wrist drop drop Adults with a distal humeral shaft fracture and who have radial nerve damage (wrist drop) can be discharged from the ER with: analgesia (Codeine) AE back-slab POP cast collar and cuff sling fracture clinic appointment may need operation (ORIF with plates)
Supracondylar fracture fracture of of distal distal humerus humerus supracondylar fracture with intracondylar extension
Supracondylar fractures fractures of of distal distal humerus humerus Adults with a displaced supracondylar fracture of their distal humerus (check ulnar nerve function) must be admitted from the ER for: analgesia (iv Acetaminophen or Morphine) collar and cuff sling keep NBM (for ORIF with plates) operation on trauma list in the OR