Open Reduction and Internal Fixation of a Pathologic Humeral Shaft Fracture

Radial nerve neurotmesis constitutes a major problem in the treatment of closed fractures of the mid-shaft of the humerus. A case of radial nerve neurotmesis associated with a closed fracture of mid-shaft of the humerus is reported. Radial nerve neurotmesis was found at the fractured site. Early exploration of the nerve and primary internal fixation of the fracture was done which gave a satisfactory result.

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

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.22.2.87 ◽

2019 ◽

Vol 22 (2) ◽

pp. 87-92

Author(s):

Chang-Hyuk Choi ◽

Chung-Mu Jun ◽

Jun-Young Kim

Keyword(s):

Internal Fixation ◽

Shaft Fracture ◽

Humeral Shaft Fracture ◽

Optimal Choice ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Group I ◽

The Mean ◽

Group Ii

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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Simultaneous palmar divergent dislocation of scaphoid and lunate concurrent with i psilateral humeroradial joint dislocation and humerus shaft fracture: report a rare case and add a new subtype

10.21203/rs.2.19896/v1 ◽

2020 ◽

Author(s):

Wan-wen Feng ◽

Ya-yi Xia ◽

Yue-peng Liu ◽

yuping liu

Keyword(s):

Open Reduction ◽

Rare Condition ◽

Humeral Fracture ◽

Shaft Fracture ◽

Humeral Shaft Fracture ◽

High Energy ◽

Humeral Shaft ◽

Scapholunate Ligament ◽

Joint Dislocation ◽

Volar Approach

Abstract Background: Simultaneous palmar dislocation of scaphoid and lunate is a rare condition generally resulting from high-energy trauma and usually classified into two types. The literature has only reported nine patients with palmar divergent dislocation of scaphoid and lunate. Here we we present a case of accompanied ipsilateral humeroradial joint dislocation and open humeral shaft fracture caused by the same violence travelling from the wrist. Considering the emerging cases with their own characteristics, we suggest this severer injury be expanded into the third type of palmar dislocation of scaphoid and lunate. Case presentation: A 31-year-old male who fell from a three-storey building, with his right wrist directly hitting the ground, was admitted to the orthopaedic department of our hospital. Physical and radiographic examinations defined simultaneous palmar divergent dislocations of scaphoid and lunate concurrent with ipsilateral humeroradial joint dislocation and open humeral shaft fracture. After debridement and internal fixation for humerus and close reduction for humeroradial joint, the scaphoid and lunate were treated with open reduction and fixation by Kirschner’s wires, and the palmar scapholunate ligament and anterior capsule were repaired through volar approach. After a 3-year follow-up, his humeral fracture healed without recurrent dislocations, collapse or avascular necrosis of scapholunate. Favorable hand function regained . Conclusions: Palmar divergent dislocation of scaphoid and lunate caused by considerable violence is rare and appropriate to urgent open reduction and fixation with Kirschner’s wires and repair of the stronger palmar scapholunate ligament through single volar approach. When the residual violence continues to transmit to the upper extremity, ipsilateral dislocation or fracture may occur. We advise that this complex injury be classified into a third subtype of simultaneous palmar dislocation of scaphoid and lunate to avoid misdiagnosis.

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