Shoulder and Elbow Cases to Consider.

Last updated Friday, August 29, 2008

Figure 1

Figure 2

Proximal humerus fracture

Clinical presentation

This is the radiograph of a 50 year old, otherwise normal woman who presented with a comminuted fracture of her proximal humerus sustained in a fall (see figure 1). She had a normal neurovascular examination.

Our concerns include :

1. Could this fracture be successfully managed non-operatively?
2. If operative intervention were necessary, what would be the best method of internal fixation?

Management

The fracture was managed nonoperatively. At 6 weeks the radiographs (see figure 2) showed early callous and the position remained acceptable so gentle motion was commenced. Twelve months later the fracture was solidly united. She had full use of her arm and a full range of movement both of her shoulder and elbow.

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