Presentation
Mechanical fall to left arm.
Patient Data
Displaced oblique fracture of the left proximal humerus. Cortical thinning and central lunacy of the humerus are suspicious for osteoporosis. Additional findings include hyper-expanded lungs with moderate diaphragmatic flattening and widely spaced ribs. Noting the history of a chronic smoker, findings are suggestive of emphysematous disease.
Case Discussion
The patient described a low impact mechanical fall onto the left shoulder. The classical clinical risk factor triad is the "elderly osteoporotic female", however such fractures can occur in the younger populace with high energy trauma.
Majority of proximal humeral fractures will occur in the greater or lesser tuberosity and the surgical or anatomic neck.
Current treatment is often nonoperative i.e. "sling immobilization followed by rehab. Nevertheless, operative management is indicated in 2 part fractures or greater and significant splitting or displacement in the younger patient.
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