Four-part fracture after intrathoracic displacement of the humeral head: a case report and review of the literature

Arch Orthop Trauma Surg. 2007 Oct;127(8):651-4. doi: 10.1007/s00402-007-0329-4. Epub 2007 Apr 21.


Displaced four-part fracture dislocation represents the highest risk of osteonecrosis of the humeral head due to a disruption of the blood supply. In a few cases, that dislocation can be intrathoracic which worsens prognosis with life-threatening injuries such as hemothorax or pneumothorax. This paper presents the case of a 77-year-old woman after having fallen down the stairs with an intrathoracic dislocation four-part fracture leaving the head in the thorax. We analyze mechanisms and review the literature in order to highlight this lesion and provide a take home message for the treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidental Falls
  • Aged
  • Arthroplasty, Replacement / methods
  • Drainage
  • Female
  • Humans
  • Joint Dislocations / etiology
  • Joint Dislocations / surgery*
  • Pneumothorax / etiology
  • Pneumothorax / therapy
  • Shoulder Fractures / etiology
  • Shoulder Fractures / surgery*
  • Thoracotomy
  • Thorax