A 69-year-old woman is brought to your facility as a trauma code after being involved in a serious motor vehicle crash. She was an unrestrained driver in a car that was hit by another vehicle and rolled over. She has had positive loss of consciousness for an unknown period of time.
Upon arrival at your facility, the patient is awake and alert, complaining of severe leg pain. Her airway is patent, she has a heart rate of 95 beats/min, and her blood pressure is 150/100 mm Hg. She has an obvious open left ankle fracture, as well as a moderate hematoma over her right upper extremity. She is, however, able to move all of her extremities, has good distal pulses, and appears to have a Glasgow Coma Scale score of 15. Radiograph of the right humerus is shown.
Answer
The radiograph demonstrates a severe fracture within the humeral neck, moderately displaced (ie, more than 50%). In addition, there appears to be a nondisplaced fracture of the neck of the radial head.
The humeral neck fracture was eventually treated with open reduction and internal fixation. The radial head fracture was managed with splinting/casting.
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