Like many orthopaedic injuries, they have a bimodal distribution, occurring in both younger patients due to high energy trauma and in elderly patients following low impact injuries due to the location of the radial nerve within the spiral groove, there is a reasonably high risk of injury. Treatment of the humeral shaft fractures minimally. Proximal humeral fractures were discussed in chapter 9. Humerus fractures functional union acceptable deformity. Principles of nonoperative treatment surgical indications. Get the definitive, two volume guide on fracture treatment, written by the worlds top orthopaedic surgeons. Most humeral shaft fractures unite if left alone in the same room. Alright, now in this part of the article, you will be able to access the free pdf download of handbook of fractures 5th edition pdf using our direct links mentioned at the end of this article. Union rates are high, and they allow for immediate weight bearing on the upper extremity in the. There has been little direct comparison between nonoperative and operative management of humeral shaft fractures. Mechanism of injury there are several unique features of the humerus that present. Backgroundhumeral shaft fractures are common but debate still occurs as to. Traditionally, humeral shaft fractures have been described according to the following features.
Distal fractures including intraarticular fractures will be included in chapter 11. Rockwood and greens fractures in adults 8th edition 2 volume set pdf free download direct link need the goto reference on adult bone and joint injuries. Midshaft humerus fracture treatment verywell health. Location proximal, middle, or distal type of fracture line transverse, oblique, spiral, comminuted, or segmental opened or closed status this article focuses on midshaft humerus fractures. Humeral shaft fracture radiology reference article. Fractures of the shaft of the humerus account for 1% to 3% of all fractures and approximately 20% of all fractures involving the bone,4 but little is known about their epidemiology. The vast majority of midshaft humerus fractures heal without surgery, which minimizes complications. Pdf download for operative versus nonoperative treatment of. The present study aimed to compare union rates and complication rates between these two modalities of treatment. Marchettivicenzi nailing appears to be a good method for the treatment of humeral shaft fractures. Epidemiology humeral shaft fractures account for 35% of all fractures 1,3. In a recent analysis comparing different treatment options in femoral shaft fractures, it could be clearly stated. Treatment of humeral shaft fractures by functional bracing has been reported to be effective in achieving high rate of fracture. Sixty humeral shaftfracture patients with a minimum age of 18 years were randomly assigned into two groups.
For the purposes of fracture classification, the lesser tuberosity marks the boundary between the proximal humerus and the midshaft. Review article management of humeral shaft fractures. Humeral shaft fractures are readily diagnosed and usually, do not require internal fixation. Humeral shaft fractures represent approximately 15 % of all fractures, occurring over 70,000 times a year in north america. Modern concepts of internal fixation of long bone shaft fractures advocate relative stabilisation techniques with no harm to fracture zone. Although they occur in all age groups, a bimodal distribution is noted. By saqib rehman md, mba, professor of orthopaedic surgery, temple university from the 9th annual philadelphia orthopaedic trauma symposium june. Many people have experienced a broken arm due to multiple causes. Humeral shaft fractures account for approximately 3% of all fractures. Willett k, alkhateeb h, kotnis r, bouamra o, lecky f.
Rockwood and greens fractures in adults 8th edition 2. Femoral shaft fractures in emergency medicine medication. Box 5000, fin90014 university of oulu, finland 2004 oulu, finland abstract although nonoperative treatment is recognized as an effective treatment method for humeral shaft. Effect of delayed treatment on open tibial shaft fractures. There is a bimodal distribution with peaks primarily in young male patients, 2 years of age, and a larger peak in older females from 6080 years of age. Dcp remains the best treatment for unstable fractures of the shaft of the humerus. The most common treatment for a humeral shaft fracture is called a fracture brace, often referred to as a sarmiento brace, named after the physician who popularized this treatment method. In contrast an indirect trauma mechanism can lead to a complex femoral shaft fracture especially in elderly patients with minor bone stock quality. The treatment of complex tibial shaft fractures by the ilizarov method. The humeral shaft supplies the attachment for a number of powerful muscles. Development of operative treatment of femoral shaft fractures.
The pectoralis major muscle inserts on the proximal shaft while the deltoid muscle attaches to. A fracture of long bone in which the fracture line passes through or across the shaft. Talk with your doctor about the best treatment plan for you. Surgical treatment is reserved for specific conditions. Adult humerus shaft fractures midwest bone and joint. Microsoft powerpoint 800 cross humeral shaft fx author. Functional treatment of closed humeral shaft fractures. Humerus shaft fracture an overview sciencedirect topics. A total of 296 patients with humeral shaft fractures met.
Fracture of the shaft of the humerus the law offices of. One of the nerves that travels from the neck to the hand, the radial nerve, spirals around the humeral shaft lying very close to the bone about. Fracture shafthumerus introduction history epidemiology mechanism of injury classification clinical features investigations treatment complications 3. A fracture of the shaft of the humerus is one of the most common bone fractures that people can develop in a car accident. Handbook of fractures 5th edition pdf free download. A midshaft humerus fracture occurs in the middle of the humerus bone and usually does.
Ebraheims educational animated video describes alternative treatment method for humeral shaft fractures. Pdf functional treatment of closed humeral shaft fractures. Nonoperative treatment is still the standard treatment of isolated humeral shaft fractures, although this method can present unsatisfactory results. Mechanism of injury there are several unique features of the humerus that. Imns are an attractive option for treatment of the humeral shaft fracture. Timing of femoral shaft fracture fixation affects length of hospital stay. Operative versus nonoperative treatment of humeral shaft fractures. This represents a growing public health concern in a climate of cost containment. Management of these fractures has been discussed in surgical texts for more than. Our tremendous staff gives back to our community by coordinating free health screenings, educational programs, and food drives. Principles of external fixation orthopaedic trauma association.
The purpose of this study is to analyze national trends in surgical management of humeral shaft fractures and determine factors predictive of surgical intervention. Hello, im ed smith, a sacramento bone fracture lawyer. Management of fractures of shaft of humerus in adults by. If youve been hurt, call me for free, friendly advice. Pdf retrograde ender nailing for humerus shaft fractures. The adobe flash plugin is needed to view this content. The spica cast group had an overall union rate of 100%, a normal lld rate of 92. A relatively high incidence of radial nerve injury has been associated with surgical management of humeral shaft fractures. The incidence of humeral shaft fractures has been increasing over time. However, good surgical outcomes can be achieved with proper patient selection.
Humeral shaft fractures treatment alternative everything. Fractures of the shaft of the humerus semantic scholar. Humeral shaft fractures were identified by the international classification. Usually, the fracture is treated in a splint or sling. Pdf treatment of humeral shaft nonunion by external. The treatment of these fractures can vary greatly depending on the age of the patient and the fracture pattern. F ractures of the humeral shaft account for approximately 3% of all fractures. Fracture of shaft of humerus accounts for 35 % of all long bone fracture. A patients guide to adult humerus shaft fractures anatomy. Retrograde ender nailing for humerus shaft fractures. This is an important step since it also establishes what will be required for the fluid system to perform as desired. We demonstrate that surgical treatment of humeral shaft fractures in the united states has been increasing over time. The humeral shaft is the middle portion of the bone with the shoulder joint at the top end and the elbow joint at the bottom.
Open fracture foster et al, jhs, 1993 14 patients with open fractures 64% 9 with nerve injury interposed or lacerated. The humerus is the long, tubular bone that makes up the upper arm. A retrospective cohort study was performed at a regional level 1 trauma centre. Conservative methods like closed reduction and application of uslab, abduction cast and splint, hanging arm cast, armbrace. A flexion trauma usually leads to a transverse fracture. Trauma specialists should be aware of a range of possible injuries, complications and be confident in their management.
Once this information is known then a final treatment design is determined and. Ppt fractures of the humeral shaft powerpoint presentation free to download id. Conservative treatment of closed fracture shaft humerus in. Both patient and fracture characteristics patient age, presence of associated injuries, softtissue status and fracture pattern need to be considered to select the appropriate treatment option. This chapter focuses on the clinical presentation, diagnosis, treatment options, and longterm prognosis of humeral shaft fractures utilizing both retrospective and prospective data ranging from. Voloshin, in shoulder and elbow trauma and its complications, 2015.
Pdf nonoperative treatment of humeral shaft fractures. Open tibial shaft fractures were analyzed retrospectively to determine the effect of treatment timing on infection and nonunion rates. Abzug, md humeral shaft fractures in children younger than 3 years of age may be associated with child abusenonaccidental trauma. Humeral shaft fractures can occur in severe accidents. Humeral shaft fracture teachmesurgeryteachmesurgery. Femoral shaft fractures are typically an emergency indication as delayed fracture stabilization is associated with an increased morbidity, and a longer hospitalization time 9. The objective of this study is to analyze the surgical results of humeral shaft fracture. Shaft fracture definition of shaft fracture by medical. I think most would define successful fracture treatment as a functional union with minimal deformity. Treatment consisted of a reamed nail in each of the 5 closed fractures, and an unreamed nail in the remaining 27. No classification scheme for humeral shaft fractures. Pdf external modular fixation for humeral shaft fracture.
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