upper limb

Proximal Humerus Fracture

intermediate

6 min

28 marks

6 questions

Clinical Scenario

A 72-year-old right-hand dominant female presents following a fall onto her outstretched hand. She complains of severe left shoulder pain and inability to move her arm. She has a background of osteoporosis and takes alendronate. On examination, there is swelling and bruising around the shoulder with tenderness over the proximal humerus. Neurovascular examination is intact.

Shoulder radiographs and CT are provided.

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Clinical image for Proximal Humerus Fracture

Source: Educational radiograph of a 4-part proximal humerus fracture • OrthoVellum Medical Education Team • OrthoVellum Educational Use

Questions

Question 1 (4 marks)

Describe the anatomy of the proximal humerus including blood supply. Why is this relevant to fracture management?

Question 2 (5 marks)

How do you classify proximal humerus fractures? Describe the Neer classification and its limitations.

Question 3 (6 marks)

What factors determine your treatment decision in proximal humerus fractures? Describe the treatment options.

Question 4 (5 marks)

Describe the indications and technique for proximal humerus fracture ORIF with locking plate.

Question 5 (4 marks)

What are the indications for hemiarthroplasty versus reverse shoulder arthroplasty?

Question 6 (4 marks)

What are the complications of proximal humerus fractures and their surgical treatment?