scholarly journals Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

2021 ◽  
Author(s):  
Jun Li ◽  
Xin Tan ◽  
Xiang Li ◽  
Pan Gou ◽  
Xiaowei Yuan ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Nerve Injury ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Dash Score ◽  
X Ray ◽  
Epidemic Period ◽  
Significant Difference

Abstract Purpose: Most of humeral shaft fractures in children could be treated satisfactorily by conservative treatment. This study aimed to evaluate the application value of ultrasonography in conservative treatment of humeral shaft fracture in children.Methods: We retrospectively reviewed children admitted to our hospital, for humeral shaft fracture from January 2014 to March 2018. The patients were divided into two groups: ultrasonography group and X-ray group. All patients were instructed to re-examined at 1 week, 2 weeks, 4 weeks, 12 weeks, 24 weeks and 1 year from the injury date for follow-up, and evaluated the prognosis according to the Disabilities of Arm, Shoulder and Hand (DASH) score at 12 months.Results: A total of 37 children were divided into ultrasonography group, 32 children were divided into X-ray group. There was no significant difference in prognosis between the two groups. The mean number of radiation exposures of ultrasonography group was less and ultrasonic examination found radial nerve injury, and using ultrasound reduced the chance of direct or in direct contact with infected peoples.Conclusion: Ultrasound is a non-invasive, non-radioactive test, which could decrease risk of COVID-19 infection and detect the vascular nerve injury caused by fracture. Ultrasonography may be the examination method for follow-up conservative treatment of humeral shaft fracture in children during the epidemic period.

scholarly journals Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

2021 ◽  
Author(s):  
Jun Li ◽  
Xin Tan ◽  
Xiang Li ◽  
Pan Gou ◽  
Xiaowei Yuan ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Nerve Injury ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Dash Score ◽  
X Ray ◽  
Fractures In Children ◽  
Epidemic Period ◽  
Significant Difference

Abstract Background: Most of humeral shaft fractures in children could be treated satisfactorily by conservative treatment. This study aimed to evaluate the application value of ultrasonography in conservative treatment of humeral shaft fracture in children.Methods: We retrospectively reviewed children admitted to our hospital, for humeral shaft fracture from January 2014 to March 2018. The patients were divided into two groups: ultrasonography group and X-ray group. All patients were instructed to evaluat the prognosis according to the Disabilities of Arm, Shoulder and Hand (DASH) score at 12 months.Results: A total of 37 children were divided into ultrasonography group, 32 children were divided into X-ray group. There was no significant difference in DASH between the two groups. The mean number of radiation exposures of ultrasonography group was less and ultrasonic examination found radial nerve injury, and using ultrasound reduced the chance of direct or in direct contact with infected peoples.Conclusions: Ultrasound is a non-invasive, non-radioactive test, which could decrease risk of COVID-19 infection and detect the vascular nerve injury caused by fracture. Ultrasonography may be the examination method for follow-up conservative treatment of humeral shaft fracture in children during the epidemic period.

scholarly journals The modified anterolateral approach to the humerus

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986595
Author(s):  
Angela Christine Chang ◽  
Ngoc Buu Ha ◽  
Christopher Sagar ◽  
Gregory Ian Bain ◽  
Domenic Thomas Leonello
Keyword(s):  
Plate Osteosynthesis ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Muscle Fibres ◽  
Anterolateral Approach ◽  
Non Union ◽  
Small Series ◽  
Brachialis Muscle

Introduction: The anterior and anterolateral approaches to the humerus describe splitting brachialis longitudinally, assuming its fibres run parallel to the shaft. Recent improvements in the understanding of brachialis anatomy however have demonstrated it has two distinct heads, with the bulk of its fibres running oblique relative to the humerus. Attempting to split brachialis longitudinally to the extent required for plate osteosynthesis invariably leads to transection of a significant number of muscle fibres. The authors present a less muscle destructive modification to the anterolateral approach (ALA) based on a bicipital brachialis muscle. Method: In order to preserve brachialis muscle fibres, the modified ALA elevates the superficial head from the underlying humerus and longitudinally splits the deep head to allow a fixation device to be tunnelled. Case notes of patients with a humeral shaft fracture fixed via the modified ALA were retrospectively reviewed. Results: Ninteen humeral shaft fractures were fixed via the modified ALA. No post-operative nerve palsies were reported. Of the 19 patients, 14 (73.7%) received clinical and radiological follow-up. All reported being satisfied with their outcome. One developed a superficial wound infection and one (previous diagnosis of spondyloepiphyseal dysplasia tarda) developed a non-union requiring revision surgery. Of the five patients lost to follow-up, two died, and three reported no ongoing orthopaedic issues via telephone. Conclusions: Improved anatomical understanding of brachialis has resulted in the described modification to the ALA which is less muscle destructive and follows a truer inter-nervous plane. This small series demonstrates satisfactory outcomes using this approach.

scholarly journals Iatrogenic Radial Nerve Palsy following Closed Reduction of a Simple Diaphyseal Humeral Fracture: Beware the Perfect X-Ray

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Morgan Jones ◽  
Hean Wu Kang ◽  
Christopher O’Neill ◽  
Paul Maginn
Keyword(s):  
Nerve Injury ◽  
Clinical Assessment ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Radial Nerve Palsy ◽  
X Ray ◽  
Radial Nerve Injury

Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.

The Holstein-Lewis Humeral Shaft Fracture: Aspects of Radial Nerve Injury, Primary Treatment, and Outcome

2008 ◽  
Vol 22 (10) ◽  
pp. 693-697 ◽  
Author(s):  
Radford Ekholm ◽  
Sari Ponzer ◽  
Hans Törnkvist ◽  
Johanna Adami ◽  
Jan Tidermark
Keyword(s):  
Nerve Injury ◽  
Radial Nerve ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Primary Treatment ◽  
Humeral Shaft ◽  
Radial Nerve Injury

THE RADIAL NERVE PALSY CAUSED BY EMBEDDING IN THE HUMERAL SHAFT FRACTURE — A CASE REPORT

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 91-93 ◽  
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura
Keyword(s):  
Radial Nerve ◽  
Traffic Accident ◽  
Nerve Palsy ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Fracture Callus ◽  
X Ray ◽  
One Year

This paper examines a case of radial nerve palsy in a 13-year-old girl caused by nerve embedded in a humeral shaft fracture. An X-ray showed a mild angular-displaced humeral shaft fracture. Two weeks later, an intramedullary Ender nailing was performed. Because of brain injury due to traffic accident, the patient lost consciousness for one month. Once she regained consciousness, radial nerve palsy was discovered and closely observed. As the radial nerve palsy had not healed after five months, the radial nerve was explored and found to be interposed between fracture sites and totally entrapped in the fracture callus. During surgery, both the proximal and distal ends of the radial nerve were cut at the surface of the humeral bone. Then, the radial nerve stumps were end-to-end sutured because of their enough length. One year after surgery, the radial nerve palsy had completely recoverd.

scholarly journals Midterm Results of Minimally Invasive Plating Osteosynthesis Versus Open Reduction and Internal Fixation for the Treatment of Mid-distal Humeral Shaft Fractures: A Case-match Controlled Comparison Study

2020 ◽  
Author(s):  
Bo Yin ◽  
Jie Gao ◽  
Huayong Zeng ◽  
Zheng Lu ◽  
Yanhong Cai ◽  
...  
Keyword(s):  
Major Complication ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Complication Rates ◽  
Comparison Study ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Distal Shaft

Abstract Background: Surgical treatment of humeral mid-distal shaft fractures is controversial. The purpose of this case-match controlled comparison study was to determine the safety and effectiveness of applying the MIPO technique compared with conventional ORIF for treating humeral mid-distal shaft fractures.Methods: This study was conducted from January 2012 to December 2016, and patients of mid-distal humeral shaft fractures were eligible for this study. The patients were followed up for a minimum period of 1 year. The clinical and radiographic outcomes were evaluated. The inclusion criteria were age between 18 to 60 years and acute displaced mid-distal humeral shaft fracture. The exclusion criteria were intra-articular fractures of the elbow, vascular insufficiency of the upper limb, pathological fracture and multiple or open fractures. The medical records and radiographs of all eligible patients during hospitalization and follow-up after discharge were reviewed. We use a 1:2 (MIPO/ORIF) case-match based on gender and age. All patients had at least 3 years of postoperative follow-up.Results: In total, 216 patients with mid-distal humeral shaft fracture underwent surgery at the departments of orthopedics of the Seventh Medical Center of PLA General Hospital and Beijing Chaoyang Hospital. Of them, 28 underwent MIPO and 56 case-matched controls underwent ORIF; all of them had complete 3-year follow-up data. No significant differences were observed in baseline characteristics between both groups. UCLA scores and MEPS were significantly higher in the MIPO group than in the ORIF group. Furthermore, UCLA score and MEPS grades in the MIPO group were significantly superior to those in the ORIF group. There was no statistically significant difference in major complication rates between both groups; however, the total major complication rate was significantly different between both groups.Conclusion: This study demonstrates that MIPO has a statistically significant clinical benefit over ORIF, including better shoulder and elbow joint function, with few overall major complications after at least 3 years of postoperative follow-up. MIPO is a safe and effective method for treating mid-distal humeral shaft fractures when surgery is indicated.

scholarly journals An Unusual Case of Humeral Shaft Non-Union

2020 ◽  
pp. 1-4
Author(s):  
Claudio Chillemi ◽  
Claudio Chillemi ◽  
Marco Damo ◽  
Nello Russo ◽  
Domenico Paolicelli ◽  
...  
Keyword(s):  
Dynamic Compression ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Complete Healing ◽  
Humeral Shaft ◽  
Left Shoulder ◽  
External Fixators ◽  
Non Union ◽  
Rotator Cuff Insufficiency

Background: Humeral shaft fractures account for 1% to 3% of all fractures and approximately 20% of all fracture involving the humerus. The prevalence of non-union for diaphyseal humeral fractures has been reported as 1% to 10% after non-surgical and 10% to 15% after surgical management. Various devices used in treatment of humeral diaphyseal non-union are limited contact dynamic compression plates, locking compression plate (LCP), wave plates, humerus interlocking nail (IMN), Ilizarov external fixators and bone graft struts. Case Description: A 68-year-old man reported a humeral shaft fracture on the left side, due to a simple fall. It was reduced and fixed by IMN. He underwent clinical and radiological follow up. Three months after the intervention, due to persistent pain and impaired function of the left shoulder, the nail was removed and a cemented endoprosthesis was implanted. 3 years later, unsatisfied with the results, he came to our attention and was diagnosed an atrophic non-union in the site of the previous humeral shaft fracture. Moreover, the exams showed a rotator cuff insufficiency. It was decided to perform a single-stage intervention to achieve two goals: cure the humeral shaft non-union and restore the function of the left shoulder. The cemented endoprosthesis was removed, followed by an extensive curettage of the non-union site. A reverse prosthesis was implanted, with an extra-long stem used to stabilize the non-union site, as it was an IMN. An allograft was harvested from a cadaver femur and fixed with two metal cerclages. The patient underwent clinical and radiological follow-up. Complete healing was achieved 8 months later. Conclusion: Humeral shaft nonunion still represent a pathology that pose a serious problem to the surgeon. A correct management should include an accurate pre-operative planning, to achieve the best result possible for the patient.

scholarly journals A Retrospective Analysis of Plate Fixation of Humerus Fracture

2021 ◽  
Vol 7 (2) ◽  
pp. 28-35
Author(s):  
Dr. Sunil Kumar Kirar ◽  
◽  
Dr. Sanjay Upadhyay ◽  
Dr. Sanat Singh ◽  
Dr. Atul Varshney ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Surgical Site Infections ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Hospital District ◽  
Non Union ◽  
Surgical Expertise

Introduction: Humeral shaft fractures represent 1–3% of all the fractures coming in our OPD.These fractures are mostly treated conservatively. Both the plate fixation and nailing techniques arebeing used but plate fixation has the advantage of lesser rates of malunion and non-union. Ourstudy aimed to evaluate the results of plate fixation in our hospital that employs plate fixation as thegolden standard. Materials and Methods: This was a retrospective cohort study of all patientstreated for a humeral shaft fracture in our hospital (District Hospital Vidisha associated with ABVMedical College, Vidisha between July 2018 and June 2020 with a mean follow-up of 6 months.Results: Plate fixation was performed in 40 patients with a humeral shaft fracture. The mean agewas 50 (SD 20) years with 60 % (n = 24) being male. There were 55 % (n = 22) fractures in theright and 45 % (n =18) fractures in the left. None of the patients develops superficial surgical siteinfection. Complications like Radial Nerve palsy, Deep surgical site infections and Non-union occurredin 2.5 % (n = 1), 2.5 % (n = 1) and 5 % (n = 2) of patients, respectively. The median duration ofradiological fracture healing was 18 (range 10–42) weeks. Conclusion: Plate fixation for humeralshaft fractures has low risks of complications. The complications can be further minimized withgreater surgical expertise.

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