71.11 Fractures of the neck of the humerus

The surgical neck of the humerus is the region between the tuberosities, and the insertions of the pectoralis and teres major. When it breaks the soft tissues hold the fragments together very satisfactorily, and provided there is some contact between them, they always unite. There is such a wide range of movement in the shoulder joint that the exact position of the fragments is unimportant. Even if the joint surfaces do not fit together perfectly, good function is still possible, but only if the patient starts to move his shoulder early. Most of these fractures need not be reduced. The only ones which you should reduce are those in which there is no contact between the broken surface of the neck and the shaft. Fractures of the surgical neck are common in children, and are not common again until middle age.

Figure 71.11: FRACTURES OF THE NECK OF THE HUMERUS. A, is an incomplete fracture in a child. B, shows considerable displacement of the shaft. There is such a wide range of movement in the shoulder joint that the exact position of the fragments is unimportant.