Glenohumeral Dislocations and Humerus Fractures

Nikole Blackwell

Anatomy of the Shoulder- The glenohumeral joint is a ball-and-socket joint

- The humerus head (the ball) fits into the glenoid of the scapula (socket)

- The labrum is the most important piece of cartilage allows humerus to rotate with minimal friction

Glenohumeral Dislocation Causes

- Most common is when the head of the humerus is forced in an anterior direction past the labrum.

- Anterior dislocation is abduction , external rotation, and extension

- Common in football and rugby players

Glenohumeral DislocationCauses

• Initial trauma involving posteriorly directed force to a flexed, adducted, and internally rotated shoulder

• Partial dislocation, humerus head is partially out of socket

Glenohumeral Dislocation Signs

• with an anterior dislocation an athlete displays flattened deltoid contour

• carries arm slightly abducted and in external rotation

Glenohumeral Dislocation Signs

• Swelling• Numbness• Weakness• Bruising

• Pain and unsteadiness in the shoulder

Glenohumeral Dislocation Facts

• 4% of Glenohumeral dislocations are posterior

• Non-operative management is favored when dislocation presents fewer than 6 weeks, and less then 20% of humeral head defect

Glenohumeral Dislocation Facts• Dislocations most occur in

football and rugby athletes

• Rare but occasionally baseball players will suffer from dislocations– One study found traditional

rehab was insufficient for 34% of overhead athletes w/ posterior glenohumeral dislocation.

Glenohumeral Dislocation Care

• Initial care requires immediate immobilization, using a sling

• Apply cold packs to prevent hemorrhage • A doctor needs to preform closed reduction to

put the arm back in place• Remain in a sling for one week then begin

physical therapy

Glenohumeral Dislocation

• https://www.youtube.com/watch?v=rWAh2lmdxxA

Anatomy of the Humerus

• The head of the humerus is part of the shoulder

• The radial groove and deltoid tuberosity are part of the humerus shaft

• The medial and lateral epicondyles and the olecranon fossa are part of the elbow

Humerus Fracture Causes• Salter-Harris system is 5

denominations for fractures– Type I- shearing or avulsion

forces – Type II- occur same as type I

but fracture continues through metaphysis

– Type III- vertical fracture lines through epiphysis

– Type IV- fracture crosses epiphysis, epiphyseal plate

– Type V- comprehensive forces are directed to bone in an uncommon motion

Humerus Fracture causes• Complete fractures result

from impaction of proximal ulna onto distal humerus

• Impact can occur with elbow flexed or unflexed

• Occasionally happen in sports– Result of direct blow,

dislocation, or impact of falling

Humerus Fracture Signs

• X-ray examinations give positive proof• Pain• Inability to the arm• Swelling• Point tenderness• Discoloration of superficial tissue

Humerus Fracture Facts

• Humeral diaphyseal fractures account for 1.2% of all fractures

• Proximal humerus fractures account for 5.7% of all fractures

Humerus Fracture Facts

• Both types of fractures are common in elderly and older adult persons

• Fracture patterns are similar across all ages, but older people are more prone due to osteoporosis

Humerus Fracture Care• Immediate application of

splint or support with a sling• An athlete with a humerus

fracture are out of competition for 2 to 6 months, depending on severity

• Distal humerus fractures are mostly treated surgically

• Athletes are told to avoid 90/90 positioning

Sources

Glenohumeral Dislocation Pictures• http://www.emaxhealth.com/2/24/24889.html• http://biomed.brown.edu/Courses/BI108/BI108_2004_Groups/Group01/

bioghj.htm• http://www.methodistorthopedics.com/shoulder-dislocations• http://orthoinfo.aaos.org/topic.cfm?topic=a00035• http://www.orthosurgeon.co.za/content/dr-peter-smith-orthopaedic-shou

lder-instability-repair-procedures-milnerton-medi-clinic-cape• http://ehow-blog.com/shoulder-dislocation-what-is-it-and-how-to-treat-it/• http://www.shoulderdoc.co.uk/article.asp?article=755• http://www.deweyjonesmd.com/blog/shoulder-instability-injuries-by-the-

numbers/

Sources

Humerus Fractures• http://www.oxford174.com/humerus-bone-picture/• http://www.tc.umn.edu/~murp0345/mnemonics/ort

ho/• http://www.wheelessonline.com/ortho/transverse_h

umeral_shaft_fracture• https://www.mdguidelines.com/fracture-humerus-di

stal• http://www.msdlatinamerica.com/ebooks/

RockwoodGreensFracturesinAdults/sid855114.html