A 39-year-old woman, with bipolar disorder, suffered an eight-meter fall, resulting in dens and proximal and distal humeral fractures associated with migration of a 6cm humerus fragment to the left cervical region.
There were no skin breaches on admission.
Posterior instrumented C1-C2 fusion was performed along with proximal humerus stabilization through anterograde static nailing after removal and repositioning of the cervical migrated fragment.
Conclusion: High-energy trauma significantly increases treatment complexity. Understanding injury mechanism is crucial to adequately diagnose undisclosed lesions that otherwise might go unnoticed. In cases of bone migration, a thorough debridement is advised to prevent heterotopic calcifications.