Skip Navigation LinksHome > September 10, 2012 - Volume 6 - Issue 5 > Surgical options for proximal humerus fractures
OR Nurse:
doi: 10.1097/01.ORN.0000419666.27383.5a
CE Connection

Surgical options for proximal humerus fractures

Free Access
Article Outline
Collapse Box

Author Information

For more than 80 additional continuing education articles related to surgical topics, go to

Earn CE credit online: Go to and receive a certificate within minutes.

Back to Top | Article Outline

INSTRUCTIONS Surgical options for proximal humerus fractures


* To take the test online, go to our secure website at

* On the print form, record your answers in the test answer section of the CE enrollment form on page 31. Each question has only one correct answer. You may make copies of these forms.

* Complete the registration information and course evaluation. Mail the completed form and registration fee of $21.95 to: Lippincott Williams & Wilkins, CE Group, 74 Brick Blvd., Bldg. 4 Suite 206, Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.

* You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.

* Registration deadline is October 31, 2014.

Back to Top | Article Outline

* Send two or more tests in any nursing journal published by Lippincott Williams & Wilkins together and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other health care facilities on Call 1–800–787–8985 for details.

Back to Top | Article Outline

Lippincott Williams & Wilkins, publisher of ORNurse2012 journal, will award 2.4 contact hours for this continuing nursing education activity. Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.4 contact hours.

Your certificate is valid in all states.

The ANCC's accreditation status of Lippincott Williams & Wilkins Department of Continuing Education refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Surgical options for proximal humerus fractures

GENERAL PURPOSE: To provide nurses with information, indications, and techniques for surgical repair of proximal humerus fractures. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Identify indications for specific proximal humerus fracture repair procedures. 2. Discuss techniques and equipment needed for proximal humerus fracture surgeries. 3. List implications for postoperative monitoring and care of patients undergoing humerus fracture repair.

1. Neer classification system determines displacement by assessing all except

a. the affected segments of the humerus.

b. vascular isolation in the area of the fracture.

c. the separation and angulation of the separated fragments.

d. the number of fragments present.

2. Arthroplastic surgery for a proximal humerus fracture may be the best choice for

a. patients younger than 70 who have a fracture older than 4 weeks.

b. comminuted fractures.

c. patients over age 70 who have osteoporosis.

d. fractures that can't be medically managed.

3. The CRPP procedure is a good option for treating proximal humerus fractures if

a. there's healthy bone quality and minimal comminution.

b. the patient is older than 70 and can't actively participate in rehabilitation.

c. the patient has significant osteoporosis.

d. there's significant comminution.

4. The CRPP procedure often results in

a. decreased risk of AVN.

b. significant internal scarring.

c. a distorted postoperative appearance.

d. poor quality bone healing.

5. During a CRPP, a post may be placed between the arm and the chest to

a. prevent vascular compromise of the humerus.

b. allow shaft lateralization.

c. allow better visualization of the operative area.

d. facilitate fluoroscopy.

6. Pins placed during a CRPP should be cut

a. 3 cm outside the surface of the skin.

b. 1 cm outside the surface of the skin.

c. flush with the skin surface.

d. below the surface of the skin.

7. Patient education following a CRPP should include

a. biweekly X-rays.

b. use of a sling with total immobility.

c. active range of motion (ROM) only after all pins are removed.

d. strengthening exercises after 8 weeks.

8. Intramedullary nailing can only be used to repair a proximal humerus fracture if

a. the head of the humerus has a good blood supply.

b. there's a risk of decreased vascularity to the head of the humerus.

c. the patient has significant osteoporosis.

d. the humeral head is stable in relation to the shaft.

9. The nail implant procedure may involve all of the following except

a. a laminar spreader to compress the head to the shaft.

b. a bone tamp to reduce the head.

c. K wires for temporary fixation.

d. a drill to make the initial hole.

10. A longer nail and interlocking screws are used to perform a nail implant if the

a. vascular supply to the head of the humerus is compromised.

b. displacement of the fracture is more than 5 mm.

c. shaft of the humerus is fractured and comminuted.

d. bone shaft can't be reamed.

11. Immediately postoperatively, how is proper intramedullary nail fixation often determined?

a. ROM under fluoroscopy

b. standard radiographs

c. bilateral arm measurements to assure equal lengths

d. proper fixation can't be determined for 2 to 3 weeks

12. A locking plate is useful for patients with osteoporosis because the plate

a. has minimal effect on the vascular supply of the bone.

b. doesn't need to be attached at multiple points.

c. can easily be moved if placed incorrectly.

d. has a fixed angle and multiple screws that attach a large amount of bone.

13. Which of the following may be required during a locking plate procedure?

a. 7 to 9 screws

b. a bone graft

c. cement to attach the plate

d. a humeral component

14. Fluoroscopy must be used for a locking plate procedure to

a. ensure proper positioning of the plate.

b. ensure that the screws penetrate the joint space.

c. determine correct positioning of the screws.

d. measure the distance from the bone graft to the plate.

15. A primary hemiarthroplasty requires

a. permanent sutures for tuberosity repair.

b. three bone graft wedges.

c. a universal prosthetic stem.

d. a single bone graft wedge.

16. During a primary hemiarthroplasty, the medullary canal is initially fitted with

a. a preselected implant.

b. a bone graft.

c. cement and a nail.

d. trial implants.

17. Following reverse total shoulder arthroplasty, patients should be instructed to begin active motion exercises in about

a. 1 week.

b. 2 weeks.

c. 4 weeks.

d. 7 weeks.

Figure. No caption a...
Image Tools

© 2012 Lippincott Williams & Wilkins, Inc.