![]() ![]() frozen shoulder), in which shoulder movement is painful and limited in all orientations. The decrease in motion ranges from clinically insignificant to adhesive capsulitis (i.e. Loss of shoulder mobility is among the more common complications of proximal humerus fractures. Secure in position of most comfort for the patient.Orthopaedic outpatient follow-up in 3-4 days 13 One-part fractures are almost always treated conservatively 8,9 Minimal trauma fracture in patients >50 years, arrange bone health assessment (i.e.12 Urgent orthopaedic referral is indicated for all nerve and vascular injuries, open fractures, and fracture dislocations. 11 Further indications for referral include fracture-dislocations and joint instability. Surgical intervention is generally needed for significantly displaced multi-part fractures and thus all displaced fractures should be referred to an orthopaedic surgeon for evaluation. 3 ED Management Optionsįor the majority of one-part fractures, these can be managed conservatively: analgesia, sling/sling and swathe and range of motion exercises. ![]() 10 However, while CT imaging improves the reliability of fracture classification over radiographs alone, however there is no evidence that CT improves outcome. Additional CT imaging is recommended if fracture lines cannot be reliably detected, as seen in complex three and four-part fractures with multiple-fragmented involvement of the head and tuberosities. Standard imaging studies of proximal humeral fractures consist of true anterior-posterior, outlet and axillary view. There is usually marked swelling, pain, tenderness and bruising of the proximal portion of the arm, due to bleeding from the bone and soft tissues. 8 However, this pattern has poor non-operative results, and as the articular surface is no longer attached to any parts of the humerus which are attached to soft tissues, it has a high incidence of osteonecrosis. Four-part fracture: These fractures are uncommon.Three-part fracture: These fractures account for approximately 5% of proximal humeral fractures. ![]() 7 These fractures account for approximately 20% of proximal humeral fractures.
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