Complex Humeral Head Split Fracture Dislocation
Score and Comment on this Case
Clinical Details
Clinical and radiological findings: A 64-year-old male pedestrian was struck by a pickup truck, resulting in a complex humeral head split fracture dislocation, along with chest and head trauma. Initial stabilization was required for the chest and head injuries. Radiological evaluation revealed a severe "nut cracker" fracture dislocation of the humeral head, with one fragment dislocated anteriorly and the other posteriorly. The fracture was classified as AO/OTA 11-C3.
Preoperative Plan
Planning remarks: The preoperative plan involved an extended deltopectoral approach to achieve reduction of the humeral head split fracture dislocation. The subscapularis muscle was to be preserved, and fixation was planned using interfragmentary screws and dual plating techniques.
Surgical Discussion
Patient positioning: Not Specified
Anatomical surgical approach: Not Specified
Operative remarks:The anteriorly dislocated head fragment was reduced first, followed by the posterior fragment. Interfragmentary screws were used to achieve initial fixation of the fragments. Dual plates were then applied to provide fixation of the reconstructed humeral head. The subscapularis muscle remained intact throughout the procedure.
Postoperative protocol: Originally posted on LInkedIn by Parag Shah, Chief consultant shoulder and upper limb surgeon, Ahmedabad, india
Follow up: Not specified
Orthopaedic implants used: Orthopaedic implants used: - Interfragmentary screws - Dual plates
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31 Jul 2024
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Full Citation
Cite this article:
LinkedIn. (2024). Complex Humeral Head Split Fracture Dislocation. Journal of Orthopaedic Surgery and Traumatology. Case Report 30911627 Published Online Jul 31 2024.