Humerus shaft fracture: Difference between revisions
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Revision as of 15:48, 22 March 2016
Background
- Peaks in third and seventh decades of life (young men and osteoporotic elderly women)
- Occurs via direct blow or FOOSH
- Common site of pathologic fractures (esp breast cancer)
- Rule-out radial nerve injury (wrist drop - no ext of wrist, fingers, or thumb)
Clinical Features
- Localized tenderness, swelling, pain
Differential Diagnosis
Humerus Fracture Types
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Diagnosis
- Obtain views of humerus, elbow and shoulder
Management
- U-shaped coaptation splint (upper arm sugar-tong splint) + sling and swathe
Disposition
- Outpatient ortho referral (if adequate pain control)