Avascular necrosis of the humeral head may occur following a fracture of the proximal humerus if there is a disruption of the vascular supply.
Patient selection: fracture of the proximal humerus
Risk factors for avascular necrosis:
(1) multiple fracture fragments
(2) plate reconstruction
(3) suboptimal surgery
If there is a fracture dislocation, early surgery (< 48 hours) may decrease the risk of osteonecrosis.
Diagnosis of osteonecrosis may be made months after the trauma, so continued follow-up is indicated.
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Specialty: Surgery, orthopedic
