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A three-part fracture dislocation of the proximal humerus usually dissociates from the shaft at the level of the surgical neck or the anatomical neck. Dissociation from the shaft below this level has not reported in the literature before. Here we describe the injury of a middle aged patient with a three-part fracture dislocation of the humerus with dissociation of the head from the shaft at the level of proximal shaft humerus with a 25 years old Rush nail in situ. The dislocated head was found abutting the thoracic wall. This case report highlights the effect of stress concentration at intramedullary nail ends in the upper limb as well as the need for an extended approach when the dislocated head appears close to the thoracic wall.

Dissociation of Shaft of Humerus from Head in Threepart Fracture Dislocation due to Stress Concentration at Intramedullary Nail End