scholarly journals Co-existing fractures of the proximal humerus and humeral shaft without shoulder dislocation – a rare injury

2010 ◽  
Vol 92 (2) ◽  
pp. e25-e28 ◽  
Author(s):  
S Srinivas ◽  
A Kasis
Keyword(s):  
Shoulder Dislocation ◽  
Radial Nerve ◽  
Proximal Humerus ◽  
High Energy ◽  
Humeral Shaft ◽  
Multiple Fractures ◽  
Rare Injury ◽  
High Energy Trauma ◽  
Unusual Injury

Multiple fractures of the humerus are a rare injury and usually associated with high-energy trauma. We report an unusual injury with co-existing fractures of the proximal humerus and humeral shaft without shoulder dislocation. We discuss our experience in the diagnosis and treatment of a 39-year-old man with co-existing fractures of proximal humerus and ipsilateral humeral shaft with radial nerve deficit. He was successfully managed with open reduction and fixation of the fractures. At follow-up 1 year after injury, he is back at work and has a good range of shoulder movements. The radial nerve injury is showing signs of recovery. In high-energy trauma to the shoulder, unusual fracture patterns with associated neurovascular deficits may be seen and this case report describes our experience with one such rare injury.

Intra-articular Transcalcaneal Fracture-Dislocation Associated With Ipsilateral Transtalar Fracture: A Report of a Rare Combination

2020 ◽  
Vol 13 (4) ◽  
pp. 335-340
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Bruno Rodrigues de Miranda ◽  
Fernando Aires Duarte ◽  
Guilherme Honda Saito ◽  
Rogério Carneiro Bitar ◽  
...  
Keyword(s):  
Case Report ◽  
High Energy ◽  
Fracture Dislocation ◽  
Calcaneal Fractures ◽  
Short Term ◽  
High Energy Trauma ◽  
Rare Combination ◽  
Severe Bone Loss ◽  
Neck Fracture

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report

scholarly journals Staged Rehabilitation of Posttraumatic Dentoalveolar Defect with Distraction Osteogenesis and Dental Implants

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1604327
Author(s):  
Virendra Singh ◽  
Neha Jajodia ◽  
Pranav Gupta ◽  
Amrish Bhagol
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Dental Implants ◽  
Distraction Osteogenesis ◽  
High Energy ◽  
Alveolar Ridge ◽  
Bone Augmentation ◽  
Multiple Fractures ◽  
Anterior Mandible

Rehabilitation of posttraumatic composite defects of anterior mandible following comminution type high-energy injury often presents a reconstructive challenge. Obtaining ideal osseous and soft tissue contours in these cases is a demanding task. We discuss a case of a young man, involved in a road-side accident leading to multiple fractures in his mandible with comminution of anterior alveolar ridge. We were able to achieve excellent results by planning and treating him in five sequential stages. First, the need for rigid internal fixation was addressed followed by bone augmentation with the dynamic osteodistraction method, dental implants, and prosthesis delivery. Satisfactory aesthetics and functions were noted at a 7-year follow-up evaluation of the patient justifying the multistaged rehabilitation treatment rendered.

scholarly journals One-Year Follow-Up After Treatment of Proximal and/or Middle One-Third Humeral Shaft Fractures with a Helical Plate: Healing Rates, Complications and Functional Outcome Measures

2021 ◽  
Author(s):  
Vincent Maes ◽  
Guy Putzeys
Keyword(s):  
Radial Nerve ◽  
Plate Osteosynthesis ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Conventional Plate ◽  
One Year ◽  
Helical Plate

Abstract Background: Conventional plate osteosynthesis is a valuable treatment option in displaced proximal and/or middle one-third humeral shaft fractures. Nonetheless, this procedure can be complicated by a radial nerve palsy. To date, many surgical techniques have been developed in an attempt to minimize this high-impact complication. However, a helical plate has the potential to avoid an iatrogenic radial nerve palsy due to its design. This article aims to evaluate safety and functional outcomes of patients treated with a helical plate compared to conventional plate osteosynthesis. In particular healing rates, complications and functional outcome measures.Methods: We retrospectively included all patients with displaced proximal and/or middle one-third humeral shaft fractures who were treated with a helical plate from October 2016 until August 2018 at a single level-1 trauma center (AZ Groeninge, Kortrijk, Belgium). A self-molded long PHILOS plate (DePuy Synthes®) or a pre-contoured A.L.P.S proximal humeral plating system (Zimmer Biomet®) were used. Patient baseline characteristics and standard radiographs were obtained pre- and postoperatively. We retrospectively searched for complications. Patients were reassessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Constant Murley (CMS) and EQ-5D-5L scores with a minimal follow-up of one year.Results: The humeral shaft fractures of all sixteen patients consolidated within three months and no iatrogenic radial nerve palsies were observed. One plate had to be removed after one year due to a late infection. With a minimum follow up of one year, the mean DASH score was 22 \ 19 and the mean normalized CMS was 80 B 19.Conclusion: Operative treatment of proximal and/or middle one-third humeral shaft fractures with a helical plate is a safe procedure with good to excellent shoulder function at one-year follow-up. Contrary to conventional plate osteosynthesis, a helical plate has the potential to completely avoid a radial nerve palsy, while maintaining similar healing rates and functional outcomes.Trial registration: B396201939564. Registered on 6 MAY 2019 – retrospectively registred. Ethics Committee: Medical Ethics Committee, AZ Groeninge, Kortrijk, Belgium.

scholarly journals Managing Radial Nerve Injuries Associated with Humeral Fracture

2020 ◽  
Vol 71 (1) ◽  
pp. 400-404
Author(s):  
Vlad Carbunaru ◽  
Ana Maria Oproiu ◽  
Adrian Barbilian ◽  
Chen Feng-Ifrim ◽  
Alexandra Ciotei
Keyword(s):  
Nerve Injury ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Bone Fractures ◽  
Humeral Fracture ◽  
High Energy ◽  
Humeral Shaft ◽  
Long Bone ◽  
Radial Nerve Palsy ◽  
Radial Nerve Injury

The overall prevalence of radial nerve injury after humeral shaft fractures is up to 18% representing the most common peripheral nerve injury associated with long bone fractures. Spiral or oblique fractures of the junction between the middle and distal third of the humeral shaft are at greater risk for radial nerve injury. Iatrogenic damage to the radial nerve may also occur during manipulations of closed reduction. A prospective study between 2017-2019 following 5 patients (all male, with ages between 30 and 56 years old), who were treated at our clinic for complete radial nerve palsy after a high-energy fracture of the humerus. All the patients were followed-up for a mean of 6 months (range 4 - 15 months) post op. The first 3 cases showed the initial signs of recovery 4 weeks after the operation. In the last 2 cases a palliative radial intervention was required. The consequences of the radial nerve palsy associated with humeral fractures is strongly related to trauma mechanism. In high energy fractures, severe contusion or transection of the nerve must be expected. In this case, nerve recovery is unlikely and the patients should be informed of the poor prognosis and the need of tendon transfers.

Cases of Missed Posterior Fracture-Dislocation of the Shoulder

2020 ◽  
Author(s):  
Morteza Nakhaei Amroodi ◽  
Farzad Amouzadeh Omrani ◽  
Naser Ghanbari ◽  
Melika Alaedini
Keyword(s):  
Young Adults ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Rare Condition ◽  
High Energy ◽  
Posterior Dislocation ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
X Ray

Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79 percent of misdiagnosis is occurred in the first diagnosis. In this article, we present two patients with proximal humerus fracture-posterior dislocation the fractures of whom were diagnosed, but after the radiographic studies including x-ray and computer tomography (CT) scan, the posterior dislocation was misdiagnosed. In addition, complications, management, and avoidance of this misdiagnosis were discussed.

scholarly journals Fracture Dislocation of Shoulder

2014 ◽  
Vol 3 (2) ◽  
pp. 44-45
Author(s):  
Hemanta Kumar Manandhar ◽  
Pramod Devkota ◽  
Padam Bahadur Khadka ◽  
Chakra Raj Randey
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
Good Range

Simultaneous dislocation of shoulder with fracture of the ipsilateral humerus is extremely rare and very little reported in the literature. We report a case of forty three year old man who got right shoulder dislocation with proximal humerus fracture. The patient was treated with open reduction and internal fixation by three 4.5mm screws. The operation went uneventful and has good range of motion of the shoulder after six months of follow up. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9529   NOAJ July-December 2013, Vol 3, Issue 2, 44-45

scholarly journals Functional outcome of traumatic spinopelvic instabilities treated with lumbopelvic fixation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Emre Yilmaz ◽  
Martin F. Hoffmann ◽  
Alexander von Glinski ◽  
Christiane Kruppa ◽  
Uwe Hamsen ◽  
...  
Keyword(s):  
Functional Outcome ◽  
High Energy ◽  
Low Energy ◽  
Trauma Patients ◽  
Concomitant Injuries ◽  
High Energy Trauma ◽  
Lumbopelvic Fixation ◽  
Energy Group ◽  
And Function

Abstract The aim of this study was to assess the functional outcome after lumbopelvic fixation (LPF) using the SMFA (short musculoskeletal functional assessment) score and discuss the results in the context of the existing literature. The last consecutive 50 patients who underwent a LPF from January 1st 2011 to December 31st 2014 were identified and administered the SMFA-questionnaire. Inclusion criteria were: (1) patient underwent LPF at our institution, (2) complete medical records, (3) minimum follow-up of 12 months. Out of the 50 recipients, 22 questionnaires were returned. Five questionnaires were incomplete and therefore seventeen were included for analysis. The mean age was 60.3 years (32–86 years; 9m/8f) and the follow-up averaged 26.9 months (14–48 months). Six patients (35.3%) suffered from a low-energy trauma and 11 patients (64.7%) suffered a high-energy trauma. Patients in the low-energy group were significantly older compared to patients in the high-energy group (72.2 vs. 53.8 years; p = 0.030). Five patients (29.4%) suffered from multiple injuries. Compared to patients with low-energy trauma, patients suffering from high-energy trauma showed significantly lower scores in “daily activities” (89.6 vs. 57.1; p = 0.031), “mobility” (84.7 vs. 45.5; p = 0.015) and “function” (74.9 vs. 43.4; p = 0.020). Our results suggest that patients with older age and those with concomitant injuries show a greater impairment according to the SMFA score. Even though mostly favorable functional outcomes were reported throughout the literature, patients still show some level of impairment and do not reach normative data at final follow-up.

scholarly journals Unusual case of talus neck fracture in a paediatric patient

2018 ◽  
Vol 4 (6) ◽  
pp. 967
Author(s):  
Vipan Kumar ◽  
Anu Yarky
Keyword(s):  
Paediatric Patient ◽  
Unusual Case ◽  
Axial Loading ◽  
High Energy ◽  
Delayed Union ◽  
X Rays ◽  
Rare Injury ◽  
Elastic Resistance ◽  
Neck Fracture

<p class="abstract">Talus fracture is a rare injury in a paediatric patient. Among talus fractures, the fracture of neck of talus is more common than fracture of body of talus. This can occur because of axial loading of the talus in a dorsiflexed foot against the anterior tibia. Children’s bones are skeletally immature and hence less brittle. They have higher elastic resistance than adult bone and are less likely to fracture.However talus fractures can still occur in paediatric patients when there is history of high-energy trauma. It needs surgery and can be associated with complications like avascular necrosis, delayed union, neuropraxia and may need a revision surgery. Here we present an unusual case of a talar neck fracture in a young boy, which was a closed fracture without distal neurovascular deficit. Closed reduction and internal fixation was done with K wire and post op X rays and follow up X rays showed complete union. Patient has normal joint mobility and strength after a period of 1 year follow up.</p>

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