Malunions of the Distal Humerus

BorrelliJr., Joseph; DeLucia, Tracey A.; Murase, Tsuyoshi

doi:10.1007/978-1-0716-1124-1_5

Cited by 1 publication

(5 citation statements)

References 44 publications

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“…One patient sustained both a proximal and distal fracture at initial presentation (IDs 1 and 9) and a midshaft fracture 7 years afterward (ID 5). a Malunion definition: (1) proximal: >45° of angulation; (2) midshaft: >20° of angulation; (3) distal: >15° of varus angulation. 4,14-16 …”

Section: Resultsmentioning

confidence: 99%

“… a Malunion definition: (1) proximal: >45° of angulation; (2) midshaft: >20° of angulation; (3) distal: >15° of varus angulation. 4,14-16 …”

Section: Resultsmentioning

confidence: 99%

“…>15° of varus angulation. 4,[14][15][16] Given the small number of patients with distal humerus fractures, it is difficult to make conclusions on the outcome of nonoperative management in this patient population. Even so, distal humerus fracture can be successfully managed nonoperatively in adults patients with immobilization and close radiographic surveillance.…”

Section: Discussionmentioning

confidence: 99%

“…4,14 To our knowledge, there is no consensus on definition of distal humerus malunion based on radiographic parameters. 15 However, the most concerning complication of a distal humerus malunion is the development of cubitus varus. 15 Therefore, in this study, malunion was defined as greater than 15° of varus angulation as described by O'Driscoll et al 16 Anteroposterior radiographs were used to examine the medial and lateral cortices for proximal, midshaft, and distal humerus fractures.…”

Section: Methodsmentioning

confidence: 99%

“…15 However, the most concerning complication of a distal humerus malunion is the development of cubitus varus. 15 Therefore, in this study, malunion was defined as greater than 15° of varus angulation as described by O'Driscoll et al 16 Anteroposterior radiographs were used to examine the medial and lateral cortices for proximal, midshaft, and distal humerus fractures. Lateral, axillary, and anteroposterior radiographs of the humerus obtained in internal rotation were used to determine the anterior and posterior cortices for proximal, midshaft, and distal humerus fractures.…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

Nonoperative Management of Humerus Fractures in Patients With Ispilateral Hemiparesis or Hemiplegia

Patel

Bartoletta

Munaretto

et al. 2022

Hand (New York, N,Y.)

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Background: Patients with upper limb dysfunction from a brain injury often have different goals of treatment and expectations following a fracture of the upper extremity. This study retrospectively reviewed outcomes of nonoperative management of acute humerus fractures in patients with severe ipsilateral hemiparesis or hemiplegia. Methods: Patients who had sustained an acute humerus fracture managed nonoperatively, greater than 1 year following an upper motor neuron (UMN) injury resulting in ipsilateral severe hemiparesis or hemiplegia at a single tertiary care center from 1988 to 2019, were reviewed. Fractures were classified using the AO-Müller/Orthopaedic Trauma Association and/or Neer classifications. Primary outcome measures included House classification level of function, pain, achievement of and time to radiographic union, and the need for subsequent surgical procedures. Results: Ten distinct nonoperatively managed humerus fractures—3 proximal (11A23), 5 mid-shaft (12A2b = 1, 12A2c = 2, 12A3a = 1, 12A2b = 1), and 2 distal (13A2 = 1, 13 C1 = 1)—were identified in 8 patients (6 women and 2 men) with ipsilateral hemiparesis or hemiplegia. The median radiographic follow-up was 20 months (range: 78 days to 12 years). The median clinical follow-up was 33.5 months (range: 100 days to 12 years). All patients presented with severe pain that was absent at final follow-up. Radiographic union was achieved in all patients with a mean time to union of 90.9 ± 39.3 days (range: 35-185 days). No patients required operative management. Conclusions: Nonoperative management of humerus fractures in patients with an ipsilateral UMN injury might result in reliable pain relief and union without the need for further surgical intervention. Management of humerus fractures in this patient population should be individualized toward their goals of care.

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