Fractures of the humerus are common and may result from injury. However they are associated with pathological fracture and osteoporosis, particularly in the elderly. The humeral head articulates with the glenoid fossa of the scapula. The anatomical neck separates the greater and lesser tuberosities from the humeral head. The long head of biceps runs between the tuberosities in the bicipital groove, and the surgical neck is just below the greater and lesser tuberosities. The radial nerve runs posteriorly around the middle third of the humeral shaft in the spiral groove. The medial and lateral epicondyles are at the lower end of the humerus, and the joint surface consists of the capitulum (articulates with the head of the radius) and the trochlea (articulates with the ulna).
Fractures of the humerus usually result from falls or direct trauma. In children the possibility of nonaccidental injury should be borne in mind when taking the history and examining the child, especially in very young children. In the elderly pathological fracture should be considered.
Classification of humeral fractures is difficult. One method is to classify them as:
Proximal humeral fractures.
Humeral shaft fractures.
Distal humeral fractures.