Diagnostic of the proximal humerus fractures.
About 4-5% of all fractures are localised to the proximal end of the humerus. During the last 30 years a two-time increase has been observed. The cause was ageing of population and a higher incidence of fractures. Treatment improved owing to proper classification based on radiological diagnosis. The principles of diagnosis was presented on the basis of the literature and analysis of the clinical material. Proper assessment of the type of fracture requires precise identification the anatomical elements of shoulder joint on radiograms. At first radiological diagnosis came down to performing AP and trasnsthoracic exposures. The latter was often unclear and that is why diagnosis has been completed with axial exposures in the axillar projection. Next Y exposure has been put into effect, which was later replaced by trasnsthoracic exposure. In individual cases CT and MRI were performed. It was found that conventional plain radiograms made in AP and Y exposures were sufficient for recognition the type of fracture. When diagnosis was questionable examination had to be broadened by axillar exposure and CT performed in the stated sequence.
Obrebski
Marcin
M
Klinika Ortopedii C.M.K.P., S.P.S.K. im. Prof. Adama Grucy, Otwock.