كسور أعلى عظمة العضد - كسور العضد القريب proximal humeral fractures - broken shoulder (subtitled)

Proximal humerus fracture includes all fractures to the anatomical neck, surgical neck, greater tuberosity , or lesser tuberosity, either isolated or in combination. Symptoms and diagnosis: Initial complaints include pain and immobility of the affected upper extremity. Patient tends to hold the affected arm adducted against their side to minimize painful motion. Swelling of the affected limb appears within hours after injury. Bruising along the arm and chest wall might not appear until a few days after injury. Gross shoulder deformities can occur, particularly if the fracture is associated with a dislocation of the humeral head. patients typically have focal tenderness at the proximal humerus. Distal pulses should be palpated in every case, A careful neurovascular exam should be conducted with particular attention to the axillary nerve. Classification: Neer classification. A fracture without displaced fragments is a “one-part”, regardless of the number of fracture lines. “Two-part fractures” have one displaced fragment, Three-part fractures are defined by two displaced fragments, Four-part fractures are defined by three or more displaced fragments. Treatment: Nonoperative treatment includes immobilization in a standard sling or collar and cuff sling in the resting position. closed reduction percutaneous pinning: open reduction and internal fixation should be used. Intramedullary nailing: Open reduction and internal fixation with either locking plates or sutures shoulder arthroplasty: Hemiarthroplasty Reverse total shoulder arthroplasty Recovery after surgery: