HUMERAL SHAFT FRACTURE TREATMENT EBOOK

Most patients with fractures of the humeral shaft are treated conservatively (non‐surgically) (Carroll ). However, this can result in serious. All of these techniques have been used successfully, but closed humeral shaft fractures are usually treated with a hanging arm cast or a coaptation splint for weeks, after which period they are placed in a functional brace. In some cases, a functional arm brace can also serve as initial treatment. The majority of both proximal and midshaft humerus fractures are nondisplaced and can be treated conservatively (nonsurgically). Nonstress.


HUMERAL SHAFT FRACTURE TREATMENT EBOOK

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HUMERAL SHAFT FRACTURE TREATMENT EBOOK

Two-part proximal fractures may require open or closed reduction depending on neurovascular injury, rotator cuff injury, dislocationlikelihood of union, and function.

For three- and four-part proximal fractures, standard practice is to have open humeral shaft fracture treatment and internal fixation to realign the separate parts of the proximal humerus.

A humeral hemiarthroplasty may be required in proximal cases in which the blood supply to the region is compromised. In shaft and distal cases in which complications such as damage to the neurovascular bundle exist, then surgical repair is required. The entire extremity is draped free.

For the posterior approach we prefer a lateral decubitus patient positioning. The extremity is draped free and well-padded elbow positioner is secured to the operating table.

Comprehensive online reference in daily clinical life

Alternatively, a sterile padded mayo stand can be utilized. Although it is possible to position the patient prone for the posterior approach it is our preference to avoid prolonged prone positioning when possible and therefore the lateral decubitus positioning is favored.

HUMERAL SHAFT FRACTURE TREATMENT EBOOK

Surgical Technique Open reduction and plate fixation Open reduction and plate fixation ORIF with plate fixation has been associated with the best functional results and is our fixation method of choice for the vast humeral shaft fracture treatment of humeral shaft fractures.

It allows direct fracture reduction and stable fixation of the humeral shaft without violation of the rotator cuff as would be required with an intramedullary nail. For most adults a 4. Primary bonehealing is the goal in most cases and therefore compression plating and lag screws are ideal.

In comminuted fractures a bridge plating technique may be appropriate, however, this requires that meticulous dissection be performed and that the periosteum remains attached to the bridged fragments.

Locked plates may be appropriate in bridge plate constructs or in osteoporotic bone but they are not routinely required. In fractures with metaphyseal extension to the distal humerus or to the proximal humerus specialized plated and extensile approaches as detailed above may be required.

The status of radial nerve must be checked throughout the procedure and careful attention should be given to avoiding injury to humeral shaft fracture treatment nerve with hardware placement. Submuscular plating techniques for the humeral shaft have been described but these are complicated techniques and are not recommended as a routine treatment option.

Intramedullary fixation Intramedullary fixation remains an attractive option for humeral shaft fractures. However, injury to the rotator cuff insertion humeral shaft fracture treatment subsequent shoulder pathology have made this technique less popular.

Additionally, studies indicate higher union rates with plating of the humeral shaft.

Intramedullary nailing is often considered in long segmental fractures where plate placement would humeral shaft fracture treatment significant soft tissue dissection and possibly humeral shaft fracture treatment submuscular plating technique.

Pathologic fractures as well as fractures in extremely osteoporotic bone have also been classically treated with intramedullary fixation.

When utilizing intramedullary nailing the proximal locking bolts may pose an injury risk to the axillary nerve.

Many surgeons prefer to make a small anterolateral approach to visualize and protect the radial nerve as the nail is passed across the fracture in order to avoid potentially injuring the radial nerve during nail passage.

HUMERAL SHAFT FRACTURE TREATMENT EBOOK

Distally lateral to medial locking risks injury to the lateral antebrachial cutaneous nerve as well as humeral shaft fracture treatment radial nerve.

A polytrauma patient someone with multiple broken bones usually has this fixed to allow for a faster rehab. If surgery is performed, there are multiple ways to do it.

Management of Humeral Shaft Fractures; Non-Operative Versus Operative

This includes using an intramedullary nail goes down the center of the humerusor humeral shaft fracture treatment plate with screws. A plate has been shown in many studies to have less risk for future shoulder impingement, reoperation, and nonunion failure to heal.

What is the outcome?

HUMERAL SHAFT FRACTURE TREATMENT EBOOK

Sometimes it takes a few months to regain the strength to return to normal activities, even if everything goes perfectly as planned.



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