Emergency Medical Minute14 Jul 2021

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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