- See:- Anterior Dislocation of the Shoulder
- Posterior Shoulder Dislocation
- Proximal Humeral Fracture
- Three Part Fracture Dislocation
- Discussion:
- frx dislocations may be considered an extension of two, three, and four part frx classifictions;
- ultimate prognosis depends on the appearance of AVN and nonunion;
- presence of atleast one intact tuberosity usually ensures enough blood supply to prevent AVN;
- exam considerations:
- note high prevelence of axillary nerve palsy, which may manifest as an postoperative pseudoparalysis with inferior subluxation;
- Two Part Fracture Dislocation:
- 2 part anterior frx dislocation is associated w/ an avulsed greater tuberosity, or can occur thru the surgical neck;
- in older pts w/ anterior humeral head dislocations, massive cuff tears are more common than avulsions;
- satisfactory reductions w/ or w/o GEA is often acheived;
- in almost all cases, closed reductions w/ no surgical rx is indicated;
- in rare cases, long head of the biceps tendon may block reduction, necessitating ORIF;
- Three Part Fracture Dislocations:
- shoulder replacement
Acute prosthetic replacement for severe fractures of the proximal humerus.