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Khajeh Alizadeh Attar M, Nakhaei Amroodi M, Bahaeddini M, Mahdavifar M, Tabrizian P. Anatomical Neck Fracture of the Humerus: Two Rare Cases and Functional Outcomes. JROS 2026; 13 (1) :25-30
URL: http://jros.iums.ac.ir/article-1-2315-en.html

Background: Pure fractures of the anatomical neck of the humerus are rare and potentially serious injuries due to the risk of complications such as avascular necrosis (AVN) and functional impairment. When associated with lesser tuberosity fractures, management becomes more complex and requires precise surgical intervention. 
Case Presentation: We report two cases of young men who sustained a shoulder injury after falling from a high place. Clinical examination revealed severe pain, swelling, and restricted range of motion. Radiographic and computed tomography (CT) imaging demonstrated a fracture of the anatomical neck of the humerus with an associated lesser tuberosity fracture. The patients underwent open reduction and internal fixation via a deltopectoral approach. The humeral head was stabilized using Herbert screws, and the lesser tuberosity was fixed with Ethibond sutures. Postoperative rehabilitation included early passive motion and progressive physiotherapy. Follow-up at 3 and 6 months showed satisfactory fracture union, improved shoulder function, and no evidence of AVN.
Conclusion: Early diagnosis, appropriate surgical fixation by an experienced shoulder surgeon, and structured rehabilitation can result in favorable functional outcomes in complex proximal humerus fractures involving the anatomical neck and lesser tuberosity.