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Humeral Shaft Fractures
Posted: Dec 8 2020 #(C101664)
B

Open humeral shaft fracture 60M

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HPI

60-year-old male presents as a level 2 trauma following a pedestrian struck by car injury. Complains only of left humerus pain

PMH

No significant PMH

PE

2 cm wound on the anterolateral aspect of the proximal arm. + gross deformity to the left arm. Significant crepitance and pain with any motion of the arm. Unable to move the wrist in flexion or extension or perform any cardinal hand motions. Sensation is not intact to the radial nerve distribution of the hand. 2+ radial pulse with BCR in all fingers

Poll
1 of 12
In addition to the radiographs provided, would you obtain any further imaging to guide your treatment?
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P: 123272
Would you use a classification system to guide management?
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P: 123273
Upon initial evaluation in the emergency department, how would you manage the wound?
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P: 123504
If you choose to give Antibiotics, what route would you prescribe?
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P: 123505
How would you definitively manage this patient?
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P: 123275
If you choose Operative management, what surgery would you perform?
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P: 123276
If you choose Operative management, does the presence of a radial nerve palsy change your treatment selection?
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P: 123280
If you choose Operative management, would you explore the nerve at the time of surgery?
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P: 123501
If you choose Operative management, attained the construct below, and were able to close the wound, what duration of postoperative antibiotics would you prescribe?
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P: 123506
If you choose Intramedullary nail (IMN) fixation and attained the construct below, would you immobilize the patient postoperatively?
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P: 123278
If you choose Intramedullary nail (IMN) fixation and attained the construct below, what weight bearing status would you assign the patient postoperatively?
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P: 123279
If you choose Intramedullary nail (IMN) fixation without radial nerve exploration and attained the construct below, when would obtain an EMG/NCS postoperatively?
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P: 123502
PROCEDURE #1

1) TREATMENT OF HUMERAL SHAFT FRACTURE WITH INTRAMEDULLARY IMPLANT - 24516 2) IRRIGATION AND DEBRIDEMENT OF OPEN LEFT HUMERUS FRACTURE -11012

Intra-procedure P1
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