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HUMERUS SHAFT FRACTURE

INTRODUCTION
A humerus fracture refers to a bone fracture of the arm
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They can occur in all age groups, the first peak is seen in the third decade in males, and the
second peak in the seventh decade in females
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It consists of three sections (the upper extremity, the body, the lower extremity)

It contains some important bony landmarks such as the deltoid tuberosity and radial groove
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An example is a blow
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BIRTH INJURIES: This is the second most common birth
fracture after clavicle
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SIMPLE FRACTURES
o
o
o

A1: Simple spiral
A2: Simple short oblique
A3: Simple transverse

WEDGE FRACTURES
o

B1: Spiral wedge

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o

B2: Bending wedge
B3: Fragmented wedge

COMPLEX PATTERN FRACTURE
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o
o

C1: Complex spiral
C2: Segmental fracture
C3: Irregular comminuted fracture

CLINICAL PRESENTATION
Patients with humeral shaft fractures present with;
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
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Arm pain
Deformity
Swelling
The arm is shortened, with motion and
crepitus on manipulation
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Injury to radial nerve is
common in fractures at the spiral groove or lower
one-third of humerus
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These should be taken at 90° angles to
each other
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It helps to study the level and
pattern of the fracture

TREATMENT
CONSERVATIVE METHOD

This consists of splinting the fracture if it is undisplaced
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Simple splint in birth fractures
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 Hanging cast is useful in older children and adolescents
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They are not suitable if the level of fracture corresponds to the upper limit of the cast,
because of the deforming effect of the proximal end of the cast
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If the cast is too heavy, it may cause distraction and consequent delayed
or nonunion
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

Functional cast brace (Sarmiento): This uses the muscular force to both reduce
and retain the fracture
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OPERATIVE TREATMENT
INDICATIONS
 Failed conservative treatment
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• Multisystem injuries
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• Pathological fractures
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• Segmental fractures
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• Brachial plexus injuries
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OPERATIVE METHODS


DYNAMIC COMPRESSION PLATE

for fractures at all levels
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LCDCP is preferred
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

INTRAMEDULLARY FIXATION at middle third fractures
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 MULTIPLE FLEXIBLE RETROGRADE IM NAILING
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

OPEN REDUCTION AND RIGID INTERNAL FIXATION with DCP plate and screws is the
recommended method
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It may also be damaged in the spiral groove
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If a radial nerve deficit occurs after closed manipulations, immediate exploration is
necessary
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It requires repeated assessment and
prompt treatment
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Thick muscles in the upper arm usually
conceal the malunion
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This
requires open reduction, excision of the fibrous tissue, rigid plating and bone grafting
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medscape
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org/articles/humeral-shaft-fracture-1
Https://www2
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org/wps/portal/surgery?bone=humerus&segment=shaft&showpage=appr
oach
Http://teachmeanatomy
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wikipedia

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