ORTHOPEDICSTREATMENT
Reduction
COMPLICATIONS
Elbow fractures in 30–60% of cases; brachial artery injury
ANTERIORELBOWDISLOCATION
DIAGNOSIS
Elbow is usually in full extension with forearm supinated.
TREATMENT
Reduction
COMPLICATIONS
■ Avulsion of triceps is common.
■ Very high incidence of vascular impairment especially brachial artery
Humerus Injuries
HUMERALSHAFTFRACTURE
TREATMENT
■ Nondisplaced humeral shaft fractures require stabilization with sugar-tong
and sling and swathe.
■ Displaced humeral shaft fractures or fractures with neurovascular compro-
mise need orthopedic consult.
COMPLICATIONS
Adhesive capsulitis of the shoulder, delayed union, radial nerve injuries, brachial
artery injuries; less commonly ulnar and median nerve injuries
PROXIMALHUMERUSFRACTURE
■ Neer classification
■ Based on the number of displaced segments of the proximal humerus
■ Significant fragment displacement is >1 cm separation or greater than
45° of angulation between fragments.
■ 85% are classified as two-part nondisplaced (surgical neck).
TREATMENT
■ Proximal humeral fractures with no significantly displaced segments are
treated with immobilization and early range of motion.
■ Fractures with any displaced segments need to be referred to orthopedics
for operative management.
COMPLICATIONS
Brachial plexus injury, axillary nerve or artery injuries, posterior shoulder dis-
location, adhesive capsulitis, avascular necrosis of the humeral head
Radial nerve injury causes
weakness of the extensors of
the wrist and digits and
numbness of the dorsoradial
aspect of the hand.