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Anatomical Neck of the Humerus

collum anatomicum humeri

The anatomical neck of the humerus is the constriction at the articular margin of the humeral head, marking the attachment of the glenohumeral joint capsule and the site of the epiphyseal growth plate in children. It separates the humeral head articular surface from the greater and lesser tubercles. The retinacular blood vessels supplying the humeral head run in the periosteum of the anatomical neck.

Region: Shoulder

Clinical Relevance

Clinical Notes

Isolated fracture through the anatomical neck is uncommon but carries the highest risk of humeral head avascular necrosis (AVN) because the retinacular vessels supplying the head run through this periosteum and are disrupted. Anatomical neck fractures in elderly patients are associated with near-certain AVN and are typically managed with hemiarthroplasty or reverse total shoulder replacement rather than internal fixation. In children, Salter-Harris physeal injuries at the anatomical neck level are common from falls.

Pathology

Common Injuries & Conditions

Avascular Necrosis Risk in Anatomical Neck Fracture

Fracture through the anatomical neck disrupts the periosteal retinacular vessels supplying the humeral head, producing near-certain avascular necrosis in elderly patients; primary hemiarthroplasty or reverse shoulder replacement is preferred over ORIF in this population because of the predictable AVN outcome with fixation alone.