• Arun Aneja, Nicholas B Jew, Matthew L Graves, and Kendall McKenzie.
• Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, Mississippi.
• J Emerg Med. 2013 Oct 1;45(4):e99-102.

BackgroundSkin dimpling, also known as skin puckering, is a rare occurrence after closed proximal humerus fractures. This finding is suggestive of incarceration of the skin at the fracture site and may lead to necrosis and conversion to an open fracture.ObjectivesOur goal is to describe our experience with skin dimpling after a proximal humerus fracture to increase awareness and recognition of this clinical presentation in the Emergency Department (ED).Case ReportWe report a case of a 46-year-old woman who presented to the ED with left shoulder pain and swelling after a fall. She was found to have skin dimpling over the anterior aspect of the shoulder on further examination and was diagnosed with a proximal humerus fracture after imaging.ConclusionSkin dimpling is an uncommon sign associated with proximal humerus fractures that can help in diagnosis and determining course of treatment. Devastating soft tissue injury can occur if the fracture is not immediately reduced. Therefore, it is imperative that physicians be able to promptly identify the clinical presentation to prevent unwanted sequelae.Copyright © 2013. Published by Elsevier Inc.

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