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Shoulder Case 5 ED Management

ED management for one-part fractures includes a sling, pain control and routine orthopedic follow-up.

For two-part fractures, management is typically percutaneous pinning.

Three-part fractures are typically managed by open reduction and internal fixation.

Four-part fractures typically require hemiarthoplasty.

Two, three and four-part fractures should have more timely orthopedic follow up due to the high likelihood of surgical intervention.

These are generalizations and depend on the individual surgeon.

Fractures of the anatomic neck (which is located proximal to the surgical neck) are at risk for avascular necrosis due to the distal-to-proximal vascular supply of the proximal humerus. Therefore, these fractures should have close orthopedic follow-up regardless of the Neer classification.