This usually occurs in adults or elderly patients as a result of an indirect mechanism.
If, after a forward or sideways fall, the patient uses an arm to act as a lever to
get back up, with the shoulder tip or joint serving as a support, there is a possibility
that the internal or external twisting motion can cause the neck of the humerus
to fracture, also known as a subcapital fracture.
Other factors such as osteoporosis or muscular atrophy can also have a direct
influence, and patients suffering from these conditions are the most vulnerable
to suffering from these types of fracture.
Presence of tolerable pain and mobility partially preserved with the patient
believing that the injury is a simple bruise.
Persistent pain, functional disability, especially in shoulder abduction movements,
and linear ecchymosis on the inner arm indicate the presence of a neck of
In cases where the fracture is stable or where surgery is not indicated, orthotic
devices can be used for conservative treatment in order to enable alignment,
immobilisation and stabilisation of the fractured segment, including stabilisation
and unloading of the glenohumeral joint, as well as compression to produce a
strapping effect on the arm. These functions create optimum conditions for the
consolidation of the fracture, allowing movement of the elbow and leaving the
hand free to perform the necessary rehabilitation and simple household chores.
These orthoses are also useful for stabilisation and protection in cases where
pseudarthrosis is present in the fracture site.