Shoulder: a fracture dislocation

This was a proximal humerus fracture sustained after a simple fall. Age of patient circa 50.

The xray above shows a proximal humerus fracture with a separate head piece, a separate greater tuberosity, and then the shaft. The head piece is dislocated from the glenoid. Hence the term fracture dislocation.

The following two xrays at the end of surgery show

  1. Relocation of the glenohumeral joint. "The ball is in the socket." This is best seen in the second intraoperative xray.
  2. The humerus fracture has been reduced. The bone pieces have been placed in the correct position relative to each other.
  3. The fracture is stabilized by a plate-and-screws implant. This particular implant is made of a stainless steel alloy, it is sold in the US by Synthes, and it works well for these fractures, at least in my hands.

With stable internal fixation, physical therapy was started within a week after surgery to avoid the otherwise very common complication that is the frozen shoulder.

Follow up for more than a year showed no development of humeral head avascular necrosis, full healing of the bone, and full flexibility: the patient was able to forward flex above 160 degrees. Here's the xray with the fracture healed.