Very common, usually through the surgical neck (fractures through anatomical neck are rare)

Anatomical neck fractures which are displaced by >1cm carry a risk of avascular necrosis to the humeral head.

Management

• Impacted fractures of the surgical neck are usually managed with a collar and cuff for 3 weeks followed by physiotherapy.
• More significant displaced fractures may require open reduction and fixation or use of an intramedullary device.

Complications

• Risk damage to the circumflex arteries supplying the head of the humerus
• Risk damage to the axillary nerve
• Risk of vascular damage to the profunda brachii artery in a spiral groove humerus fracture