M.E.Müller: Atlas: Fracture 11-C3

Humerus, Proximal,
articular fracture,
dislocated 0,19% of the total
2,68% of the humerus
06,55% of the segment

7 fractures
6,7% group
49%M, 51%F

64 fractures
61% group
39%M, 61%F

34 fractures
32,3% group
29%M, 71%F

Anatomical neck +Q Anatomical neck and tuberosities +Q Cephalotubercular fragmentation +Q

These are fractures of the proximal humerus, articular at the level of the anatomic neck. The degree of displacement determines the group, C1 corresponds to fractures with slight displacement, C2 corresponds to the impacted fractures with marked displacement and C3 to the fractures associated to a glenohumeral dislocation. The subgroups correspond to several combinations. Ref. Manual of Internal Fixation:
184 - 187. 438 - 441.
Surgeon. LO, RO.

These are fractures of a very bad prognosis because of the high risk of avascular necrosis of the humeral head, quite frequent in young patients. All fractures of the anatomical neck will completely interrupt the epiphyseal blood supply, thus its survival will depend on the revascularization coming from the metaphyseal environment. Impacted fractures should not be disimpacted.

The worse prognosis corresponds to the fractures

associated with a gleno-humeral dislocation. Intricate attempts give unacceptable results. Rigidity, often painful, is the usual result. Of the illustrated cases, the first one had an acceptable result and the second suffered avascular necrosis. Probably, immediate prosthetic replacement, a technique that we have not yet assumed, will give better results in the future. On the other hand, conservative treatment can give acceptable degrees of pain and functional results in spite of disastrous radiographical appearences.

preoperative postoperative + 1 year

preoperative + 4 months + 1 year




						Humerus, Proximal, articular fracture, dislocated	0,19% of the total 2,68% of the humerus 06,55% of the segment






These are fractures of the proximal humerus, articular at the level of the anatomic neck. The degree of displacement determines the group, C1 corresponds to fractures with slight displacement, C2 corresponds to the impacted fractures with marked displacement and C3 to the fractures associated to a glenohumeral dislocation. The subgroups correspond to several combinations.		Ref. Manual of Internal Fixation: 184 - 187. 438 - 441. Surgeon. LO, RO.

These are fractures of a very bad prognosis because of the high risk of avascular necrosis of the humeral head, quite frequent in young patients. All fractures of the anatomical neck will completely interrupt the epiphyseal blood supply, thus its survival will depend on the revascularization coming from the metaphyseal environment. Impacted fractures should not be disimpacted. The worse prognosis corresponds to the fractures	associated with a gleno-humeral dislocation. Intricate attempts give unacceptable results. Rigidity, often painful, is the usual result. Of the illustrated cases, the first one had an acceptable result and the second suffered avascular necrosis. Probably, immediate prosthetic replacement, a technique that we have not yet assumed, will give better results in the future. On the other hand, conservative treatment can give acceptable degrees of pain and functional results in spite of disastrous radiographical appearences.