Proximal Humerus Fracture

Proximal humerus fractures can injure the axillary nerve, which can present as:

• Change in sensation over the lateral shoulder (“regimental badge” area)
• Impaired shoulder abduction (after the first 15 degrees)

Management principles in those with displaced low-energy fractures (adults):

• Offer non-surgical management for uncomplicated injuries
• Consider surgery for those complicated by ANY of the following:
  • Open wound (i.e. open fracture)
  • Tenting of the skin
  • Vascular injury
  • Fracture dislocation or a split of the humeral head

References