The standard of care for evaluation of proximal humerus fractures includes obtaining the requisite radiologic studies to visualize the proximal humerus in three planes, typically anterior/posterior (AP), lateral, and axillary views, to help delineate the fracture pattern. It is absolutely necessary to understand the fracture pattern in order for the treating physician to make treatment recommendations to patients and their family members, based on the best available medical evidence.
For patients with proximal humerus fractures, it is often difficult to get axillary x-rays because of pain, and difficulty with patient positioning. There are several different views that can be attempted, but they often are suboptimal in patients who are obese, When proper x-rays of proximal humerus fractures cannot be obtained, the standard of care is to perform a CT scan of the shoulder, which provides imaging in coronal, sagittal, & axial planes, allowing clear analysis of the fracture pattern.
Proximal humerus fracture medical expert witness specialties include orthopaedic surgery, pediatric orthopaedic surgery, and radiology.