Objective To investigate causes of misdiagnosis and missed diagnosis of occult humeral head fracture and to provide preventive measures. Methods Clinical data of 7 patients with missed diagnosis or misdiag-nosis of occult humeral head fracture admitted to our hospital between January 2013 and January 2017 was retrospec-tively analyzed. Results All the patients complained of shoulder pain with limitation of motion. There were no obvi-ous signs of fracture of the humeral head on the initial X-ray examination. Three patients were diagnosed as shoulder dislocation with avulsion fracture of greater tubercle of humerus, two patients were diagnosed as avulsion fracture of greater tubercle of humerus, and 2 patients diagnosed as soft tissue contusion. All cases were misdiagnosed as humer-al head fracture. The duration of misdiagnosis and missed diagnosis was 1 d-2 w. CT scanning of shoulder joint con-firmed humeral head fracture in all seven patients. Of them, 4 patients received internal fixation, and plaster outer- fixation was performed in 3 patients. At an average follow-up period of 6-24 months, all patients had excellent frac-ture union, and shoulder function was significantly improved. Conclusion Occult humeral head fracture is easily misdiagnosed or neglected. For those with highly suspected occult humeral head fracture but with negative X-ray find-ings, CT scan should be performed in order to prevent missed diagnosis or misdiagnosis.%目的 探讨隐匿性肱骨头骨折的误漏诊原因及防范措施.方法 回顾性分析我院2013 年1月—2017年1月收治的隐匿性肱骨头骨折误漏诊7例的临床资料.结果 7例首发症状均为肩关节局部疼痛伴活动受限,病初X线检查肱骨头均无明显骨折征象,3例诊断为肩关节脱位伴肱骨大结节撕脱性骨折,诊断为肱骨大结节撕脱性骨折及软组织伤各2例,均漏诊肱骨头骨折.误漏诊时间1d～2周. 7例均经肩关节CT检查确诊肱骨头骨折.确诊后,4例行手术内固定治疗,3例行石膏外固定保守治疗.随访6～24个月,骨折均愈合,肩关节功能明显改善.结论 隐匿性肱骨头骨折极易误漏诊,对于高度怀疑隐匿性肱骨头骨折而X线检查无明显异常者应进一步行肩关节CT检查,防止误漏诊.
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