S42.23

Clinical Causes: Falls, especially in older adults Traumatic accidents such as car or motorcycle crashes Direct blows to the shoulder Osteoporosis weakening the bone structure

Key Symptoms: Severe pain in the shoulder and upper arm Swelling and tenderness around the shoulder Limited or inability to move the shoulder Deformity or abnormal positioning of the upper arm Bruising or discoloration around the shoulder area

Diagnosis Path: Diagnosis of a 3-part fracture of the surgical neck of the humerus is primarily made through physical examination and imaging tests. Healthcare providers will assess shoulder movement, check for deformity, and evaluate blood flow and nerve function. X-rays are the primary imaging modality used to confirm the presence and details of the fracture, revealing how the bone is broken into three parts. Sometimes, additional imaging such as CT scans may be ordered to get a clearer picture of complex fractures.

Treatment Protocols: Treatment options depend on the patient's age, overall health, activity level, and the severity of the fracture. Common treatment approaches include: - **Conservative management:** In some cases, especially in older adults with lower activity demands, immobilization with a shoulder sling or brace and pain management may be sufficient. - **Surgical intervention:** More commonly for 3-part fractures, surgery may involve internal fixation using plates, screws, or pins to realign and stabilize the bone fragments. In some cases, shoulder replacement (arthroplasty) may be considered, especially if the fracture is complicated or if the bone quality is poor. - **Rehabilitation:** Post-treatment, physical therapy is crucial to restore shoulder strength, range of motion, and functionality. Recovery times vary widely based on the specific treatment method and individual healing capacity.