Humeral shaft fractures

Updegrove, Gary F.; Mourad, Wassim; Abboud, Joseph A.

doi:10.1016/j.jse.2017.10.028

Cited by 83 publications

(85 citation statements)

References 71 publications

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“…The standard gold treatment in cases of humeral diaphyseal fracture seen in the adult age group is considered to be conservative treatment. In a systematic review by Updegrove et al on humeral shaft fractures, this view has been supported; however, they thought that a specific approach would be appropriate considering the fracture type, level, and patient-specific risk factors [13]. High nonunion rates in spiral oblique-type humeral shaft fractures of the proximal region mentioned in this review are thought to be higher in the studies by Ali et al, Rutgers et al, Toivanen et al, which are in particular considered to be caused by deforming-effect of the pectoralis major and deltoid muscle [7,14,15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical and Radiological Results of Humeral Diaphyseal Fractures with Treated Sarmiento Brace

Basa

Kaçmaz

Öztürk

et al. 2020

Cureus

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Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical and Radiological Results of Humeral Diaphyseal Fractures with Treated Sarmiento Brace

Basa

Kaçmaz

Öztürk

et al. 2020

Cureus

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“…The majority of patients are young adult men who have sustained high-energy trauma to the shoulder 3 . Humeral shaft fractures, which occur mainly in the elderly and are often the result of a fall, account for approximately3% of all long-bone fractures 22 . In our hospital, dislocation of the shoulder joint with an ipsilateral humeral shaft fracture accounted for 1.44% of all humeral shaft fractures.…”

Section: Epidemiological Characteristicmentioning

confidence: 99%

“…Finally, this type of fracture has a higher nonunion rate than the distal two-thirds when treated conservatively 27,28 , suggesting that it is better to fix the fracture first. Open reduction and plate fixation is generally the preferred method compared with minimally invasive plating and intramedullary nailing for humeral shaft fractures 22 . However, in the scenario presented above, intramedullary nail fixation is more advantageous 12 .…”

Section: Treatment Of Humeral Fracturesmentioning

confidence: 99%

“…The humeral shaft is commonly defined as the segment distal to the surgical neck and proximal to the epicondyles. Fractures of the humeral shaft account for approximately 3% of all long-bone fractures 22 . The radial nerve arises from the posterior cord of the brachial plexus and runs anterior to the subscapularis muscle to penetrate the triangular interval in conjunction with the deep brachial artery, which may be injured primarily or iatrogenically.…”

Section: Introductionmentioning

confidence: 99%

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Management of Dislocation of the Shoulder Joint with Ipsilateral Humeral Shaft Fracture: Initial Experience

Lyu

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To gain a better understanding of the traumatic mechanism and to develop appropriate treatment for dislocation of the shoulder joint with an ipsilateral humeral shaft fracture. Methods: This was an observational and descriptive study. Nine patients with traumatic shoulder dislocations associated with ipsilateral humeral shaft fractures who visited the emergency room and received treatment from January 2012 to June 2018 were retrospectively analyzed. CT with three-dimensional reconstruction was performed to provide precise anatomical information of the fractures. The traumatic event and the type of fracture of the humeral shaft were analyzed to help determine the trauma mechanism. Closed reduction of the dislocation was attempted at once under intravenous anesthesia. One patient died the following day due to unrelated causes. All humeral shaft fractures of the eight patients received internal fixation, and then reduction of the dislocation was performed again if previous attempts failed. The affected limb was immobilized in a sling for 3 weeks postoperatively, and then active and passive movement was encouraged. Patients were evaluated based on clinical and radiographic examinations, shoulder joint range of motion, Constant-Murley score, and subjective shoulder value. Results: Four cases in the present study could not give a clear description of the traumatic procedure. The other five patients suffered a second strike on their upper arms when they were hurt, with low mobility and high pain in the shoulder region. Seven cases were simple fractures and two were wedge fractures. According to the AO/OTA classification system, four cases were type 12-A2, three were type 12-A3, and two were type 12-B2. Six patients successfully obtained closed manipulative reduction of the shoulder dislocation in the acute stage. The follow-up time ranged from 18 to 31 months. No deep wound infections were encountered. All fractures healed uneventfully. The union time ranged from 4 to 6 months. At the final follow-up, shoulder range-of-motion values were found to range from 140 to 170 forward flexion, 30 to 40 extension, 40 to 45 adduction, 150 to 170 abduction, 50 to 60 internal rotation, and 50 to 60 external rotation; no recurrent instability of the shoulder joint occurred; the Constant-Murley score was 89.5 AE 3.7 points (range: 84-94 points); the subjective shoulder value was 89.4% AE 6.3% (range: 75%-95%). Conclusion: Shoulder dislocation most likely occurs first with an axial force or a direct posteroanterior force and a subsequent force results in the shaft fracture. For patients with mid-distal humerus fractures, closed manipulative reduction of the joint is usually effective. After success of closed reduction, surgery for the humeral shaft fracture is advocated to ensure stability and to make patient nursing convenient. In cases with fractures in the proximal third of the humeral shaft, fixation is suggested beforehand to help reduce the shoulder dislocation.

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“…Humeral fractures account for approximately 5% to 8% of all extreme fractures, and humeral shaft fractures comprise about 3% of these [ 1 , 2 ]. Most humeral shaft fractures can be managed with non-operative treatments because they are undisplaced or minimally displaced [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

Choi¹,

Jun²,

Kim³

2019

Clin Shoulder Elbow

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Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types.Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft f?r Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20?87 years), and mean follow-up period was 2.3 years (range, 1.0?6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed.Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (p<0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (p=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (p=0.352).Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.

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Humeral shaft fractures

Cited by 83 publications

References 71 publications

Evaluation of Clinical and Radiological Results of Humeral Diaphyseal Fractures with Treated Sarmiento Brace

Evaluation of Clinical and Radiological Results of Humeral Diaphyseal Fractures with Treated Sarmiento Brace

Management of Dislocation of the Shoulder Joint with Ipsilateral Humeral Shaft Fracture: Initial Experience

A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

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