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Isolated fracture of the tubercles of the humerus: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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What causes an isolated fracture of the tubercles of the humerus?
The isolated fractures of the tubercles of the humerus mostly arise with the indirect mechanism of trauma, a frequent type of which are detachable fractures. The latter almost always occur with the displacement of fragments.
Symptoms of isolated fracture of humerus tubercles
Patients complain of pain in the place of fracture and restriction of movements in the shoulder joint.
Diagnosis of isolated fracture of humerus tubercles
Examination and physical examination
The proximal part of the shoulder is swollen, sometimes bruising and other signs of violence are visible. When palpation reveals a sharp soreness in the projection of tubercles. Active movements in the shoulder joint are limited - rotation and withdrawal are difficult, passive movements are possible, but painful.
Laboratory and instrumental research
The final diagnosis is made after mandatory radiography, since the fractures of the tubercles in some cases are not diagnosed, referring them to the bruises of the shoulder.
[Treatment of an isolated fracture of humerus tubercles
Conservative treatment of an isolated fracture of humerus tubercles
For fractures without displacement, after the procain blockade (10 ml of a 1% solution), a dezo plaster dressing is applied with a wedge-shaped cushion in the armpit creating an outlet of at least 30 ° for 3 weeks. After eliminating immobilization, a course of restorative treatment is prescribed.
In fractures with displacement, the fragments are correlated and superimposed with a draining splint or gypsum thoracobrachial bandage. The shoulder is retracted by 90 °, displaced anteriorly by 30 °. The other segments of the hands are given a functionally advantageous position. Immobilization lasts 6 weeks, then they are prescribed rehabilitation treatment.
Surgical treatment of isolated fracture of humerus tubercles
Separation of the large tubercle with its displacement to the acromion is an indication for surgical treatment. Produce an open osteosynthesis with a metal screw, Kirshner's knitting needles, or transossal sutures with chrome catgut. After the operation, immobilization is mandatory. Further tactics and timing are the same as with conservative treatment.