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

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.