title: Skin dimpling after a closed proximal humerus fracture.
abstract: BACKGROUND
  Skin dimpling, also known as skin puckering, is a rare occurrence after closed proximal humerus fractures. This finding is suggestive of incarceration of the skin at the fracture site and may lead to necrosis and conversion to an open fracture.
  
  
  OBJECTIVE
  Our goal is to describe our experience with skin dimpling after a proximal humerus fracture to increase awareness and recognition of this clinical presentation in the Emergency Department (ED).
  
  
  METHODS
  We report a case of a 46-year-old woman who presented to the ED with left shoulder pain and swelling after a fall. She was found to have skin dimpling over the anterior aspect of the shoulder on further examination and was diagnosed with a proximal humerus fracture after imaging.
  
  
  CONCLUSIONS
  Skin dimpling is an uncommon sign associated with proximal humerus fractures that can help in diagnosis and determining course of treatment. Devastating soft tissue injury can occur if the fracture is not immediately reduced. Therefore, it is imperative that physicians be able to promptly identify the clinical presentation to prevent unwanted sequelae.
authors.affiliation: Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Arun
authors.initials: A
authors.lastname: Aneja
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Jew
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Graves
authors.forename: Kendall
authors.initials: K
authors.lastname: McKenzie
mesh_terms: D005260:Female; D005596:Fractures, Closed / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D012784:Shoulder Fractures / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D012867:Skin / Q000473:pathology*
keywords: proximal humerus fractures; skin dimpling