Term
| proximal humerus fx (mechanisms, complications) |
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Definition
- mechanism- fall onto outstretched UE
- complications
- axillary N. injury (esp. w/ant. fx/dislocation)
- shoulder stiffness
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Term
| Describe Neer classification |
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Definition
- classification system for proximal humerus fractures
- Based of 4 parts
- greater tuberosity
- lesser tuberosity
- articular surface
- shaft
- Considered a "part" if:
- displacement > 1 cm
- at least 45 degrees angulation
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Term
| Indications for non-operative management of proximal humerus fracture |
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Definition
- minimally displaced (1, 2 or 3 part)
- patients who are not surgical candidates
- greater tuberosity fractures with displacement < 5 mm
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Term
| Treatment of proximal humerus surgical neck fracture in young vs elderly |
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Definition
- young- ORIF
- elderly- ORIF vs. hemiarthroplasty
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Term
| What are the deforming forces in a 2-part surgical neck fracture of the humerus |
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Definition
- pectoralis major- pulls shaft anterior and medial
- head and attached tuberosities remain stable
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Term
| What are the deforming forces in greater tuberosity fracture |
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Definition
pulled superior and posterior by the
- supraspinatous
- infraspinatous
- teres minor
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Term
| Desribe the course of the axillary nerve |
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Definition
- directly inferior to the joint capsule
- travels posteriorly with the posterior circumflex humeral artery
- bends anterior approximately 7 cm distal to the tip of the acromion
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Term
| Criteria for non-operative management of humeral shaft fractures |
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Definition
- < 20 degrees anterior angulation
- < 30 degrees varus/valgus angulation
- < 3 cm shortening
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Term
| Absolute indications for ORIF humeral shaft fx |
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Definition
- open fracture
- vascular injury requiring repair
- brachial plexus injury
- ipsilateral forearm injury (floating elbow)
- compartment syndrome
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Term
| Relative indications for ORIF humeral shaft fractures |
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Definition
- bilateral humerus fractures
- polytrauma/associated LE injuries
- pathologic fx
- burns/soft tissue injuries precluding bracing
- fracture characteristics
- distraction at fracture site
- short oblique or transverse fracture pattern
- intra-articular extension
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Term
| Relative indication for IMN humerus shaft fx |
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Definition
- pathologic fx
- segmental fx
- severe osteoporotic bone
- overlying skin trauma limits open approach
- polytrauma
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Term
| Compare complication rates between IMN and ORIF of humeral shaft fractures |
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Definition
- Higher total complication rates in IMN
- Higher rates of shoulder pain with IMN
- similar rates of nonunion and outcome scores
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Term
| Describe the course of the radial nerve in relation to the humerus |
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Definition
- courses within the spiral groove of the humerus
- 14 cm proximal to lateral epicondyle
- 20 cm distal to medial epicondyle
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