Contributor: Nick Tsipis, MD
Educational Pearls:
- Humerus fractures can be characterized as proximal, midshaft, and distal fractures
- Proximal humerus fracture is the second-most common fracture in elderly patients
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- Primary complication is with the axillary nerve and axillary artery
- Vast majority are managed nonoperatively with a sling, reduction usually not indicated
- Women comprise 70% of proximal humerus fractures, often secondary to fall with osteoporosis
- Midshaft humerus fractures are more often managed operatively, but can be managed nonoperatively
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- Primary complication is with radial nerve, look for wrist drop!
- May require reduction and splinting
- Distal humerus fractures can include supracondylar fractures and involve the radius or ulna
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- One atypical is the Holstein-Lewis fracture, that can cause radial nerve damage
- Management is varied depending on the exact type of distal humerus fracture
- Assess degree of angulation, neurovascular status, and likelihood of compartment syndrome both before and after splint application
References
Attum B, Thompson JH. Humerus Fractures Overview. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482281/
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