Which nerve and artery are at risk with fractures near the humeral surgical neck?

Which nerve and artery are at risk with fractures near the humeral surgical neck?

• A. Radial nerve and profunda brachii artery
• B. Axillary nerve and posterior circumflex humeral artery
• C. Musculocutaneous nerve and brachial artery
• D. Median nerve and radial artery

Answer: (B)

Fractures near the humeral surgical neck threaten the structures that pass directly posterior to the humerus in that region. The axillary nerve wraps around the surgical neck together with the posterior circumflex humeral artery as they travel through the quadrangular space. When a fracture occurs there, both can be damaged, leading to deltoid weakness and sensory changes over the region supplied by the axillary nerve, with potential vascular implications for the shoulder area. The radial nerve and the profunda brachii artery travel in the radial groove along the humerus, so they are more at risk with midshaft fractures, not injuries around the surgical neck. The musculocutaneous nerve lies in the anterior arm, piercing the coracobrachialis, and is not a structure that travels with the posterior aspect of the surgical neck. The median nerve and radial artery are associated with more distal, anterior-arm/forearm relationships and are not the key structures at the surgical neck.

Fractures near the humeral surgical neck threaten the structures that pass directly posterior to the humerus in that region. The axillary nerve wraps around the surgical neck together with the posterior circumflex humeral artery as they travel through the quadrangular space. When a fracture occurs there, both can be damaged, leading to deltoid weakness and sensory changes over the region supplied by the axillary nerve, with potential vascular implications for the shoulder area.

The radial nerve and the profunda brachii artery travel in the radial groove along the humerus, so they are more at risk with midshaft fractures, not injuries around the surgical neck. The musculocutaneous nerve lies in the anterior arm, piercing the coracobrachialis, and is not a structure that travels with the posterior aspect of the surgical neck. The median nerve and radial artery are associated with more distal, anterior-arm/forearm relationships and are not the key structures at the surgical neck.