closed Fracture Right Neck Humerus

A.INTRODUCTION

The proximal humerus consists of the articular surface of the shoulder

jointand the attachments of the rotator cuff to the greater and lesser tuberosities. Mosto f
the blood supply to the humeral head comes from the anterior
h u m e r a l circumflex branch of the axillary artery. More than 90% of
proximal humeralfractures result from a low-energy fall directly onto the
shoulder. Patients withosteoporotic bone are at the highest ris . !n
nonosteoporotic patients" fracturesr e s u l t f r o m h i g h - e n e rg y t r a u m a .
# e e r $ s c l a s s i f i c a t i o n d i i d e s t h e p r o x i m a l humerus into & parts

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*i . + r t i c u l a r s u r f a c e i i . , r e a t e r t u b e r o s i t y i i i . e s s e r
t u b e r o s i t y i . urgical nec 'the border between the round proximal
metaphysisand the diaphyseal portion of the bone) ./ractures are classified as
ha ing ( 12& parts" based on the number of fragments" with a fragment defined
as a part if it is displaced 3(cm and4or angulated 3&567.

B.EPIDEIO!O"#

Proximal humerus fractures comprise &% to 5% of all fractures and representthe most
common humerus fracture '&5%). The increased incidence in the older
population is thought to be related to osteoporosis. 8is for a proximal humeralfracture
increases with age" pea ing in the 9th decade. The *( female-to-male ratio
is liely related to issues of bone density

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C . A N AT O #

The shoulder has the greatest range of motion of any articulation in the body:this is due
to the shallow glenoid fossa that is only 5% the si;e of the humeralhead and
the fact that the major contributor to stability is not bone" but a soft t i s s u e
enelope composed of muscle" capsule" and ligaments.The
p r o x i m a l humerus is retroerted <5 to &0 degrees relatie to the epicondylar axis.
The four