Humerus fracture: Difference between revisions
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{{Adult top}} [[Humerus fracture (peds)]].'' | {{Adult top}} [[Humerus fracture (peds)]].'' | ||
== | ==Background== | ||
[[File:Communitive midshaft humeral fracture callus.jpg|thumb|Comminuted midshaft humeral fracture with callous formation]] | |||
{{Proximal arm fracture DDX}} | {{Proximal arm fracture DDX}} | ||
==Clinical Features== | |||
*History of trauma | |||
*Pain over fracture site | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Shoulder DDX}} | {{Shoulder DDX}} | ||
==Evaluation== | |||
===Workup=== | |||
===Diagnosis=== | |||
==Management & Disposition== | ==Management & Disposition== | ||
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*[[Fractures (main)]] | *[[Fractures (main)]] | ||
*[[Splinting]] | *[[Splinting]] | ||
==External Links== | |||
==References== | ==References== | ||
Latest revision as of 18:54, 22 March 2023
This page is for adult patients. For pediatric patients, see: Humerus fracture (peds).
Background
Humerus Fracture Types
Clinical Features
- History of trauma
- Pain over fracture site
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Evaluation
Workup
Diagnosis
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Adult Humerus Fracture Management Table
| Fracture | Splint | Disposition |
| Proximal | Non-emergent, but many need surgery, refer to ortho vs ED consult | |
| Shaft |
|
R/o neurovasc injury and compartment syndrome, but many need surgery, refer to ortho vs ED consult |
| Elbow Fracture (Adult) | Long arm posterior splint | R/o neurovasc injury and compartment syndrome, but many need surgery, refer to ortho vs ED consult |
| Olecranon |
|
R/o neurovasc injury and compartment syndrome, refer to ortho within 24 hrs |