Podcast 693: Humerus Fractures

Contributor: Nick Tsipis, MD

Educational Pearls:

• Humerus fractures can be characterized as proximal, midshaft, and distal fractures
• Proximal humerus fracture is the second-most common fracture in elderly patients 
• • Primary complication is with the axillary nerve and axillary artery 
  • Vast majority are managed nonoperatively with a sling, reduction usually not indicated
  • Women comprise 70% of proximal humerus fractures, often secondary to fall with osteoporosis
• Midshaft humerus fractures are more often managed operatively, but can be managed nonoperatively
• • Primary complication is with radial nerve, look for wrist drop!
  • May require reduction and splinting
• Distal humerus fractures can include supracondylar fractures and involve the radius or ulna
• • One atypical is the Holstein-Lewis fracture, that can cause radial nerve damage
  • Management is varied depending on the exact type of distal humerus fracture
• Assess degree of angulation, neurovascular status, and likelihood of compartment syndrome both before and after splint application

References

Attum B, Thompson JH. Humerus Fractures Overview. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482281/

 

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