Summary Humeral shaft fractures are common fractures of the diaphysis of the humerus, which may be associated with radial nerve injury. Diagnosis is made with orthogonal radiographs of the humerus. Treatment can be nonoperative or operative depending on location of fracture, fracture morphology, and association with other ipsilateral injuries. Epidemiology Incidence 3-5% of all fractures Demographics bimodal age distribution young patients with high-energy trauma elderly, osteopenic patients with low-energy injuries Anatomy Osteology humeral shaft is cylindrical distally humerus becomes triangular intramedullary canal terminates 2 to 3 cm proximal to the olecranon fossa Muscles insertion for pectoralis major deltoid coracobrachialis origin for brachialis triceps brachioradialis Nerve radial nerve courses along spiral groove 14cm proximal to the lateral epicondyle 20cm proximal to the medial epicondyle Classification OTA bone number: 1 fracture location: 2 fracture pattern: simple:A, wedge:B, complex:C Descriptive fracture location: proximal, middle or distal third fracture pattern: spiral, transverse, comminuted Holstein-Lewis fracture a spiral fracture of the distal one-third of the humeral shaft commonly associated with neuropraxia of the radial nerve (22% incidence) Presentation Symptoms pain extremity weakness Physical exam examine overall limb alignment will often present with shortening and in varus preoperative or pre-reduction neurovascular exam is critical examine and document status of radial nerve pre and post-reduction Imaging Radiographs views AP and lateral be sure to include joint above and below the site of injury transthoracic lateral may give better appreciation of sagittal plane deformity rotating the patient prevents rotation of the distal fragment avoiding further nerve or soft tissue injury traction views may be necessary for fractures with significant shortening, proximal or distal extension but not routinely indicated Treatment Nonoperative coaptation splint followed by functional brace indications indicated in vast majority of humeral shaft fractures criteria for acceptable alignment include: < 20° anterior angulation < 30° varus/valgus angulation < 3 cm shortening absolute contraindications severe soft tissue injury or bone loss vascular injury requiring repair brachial plexus injury relative contraindications see relative operative indications section radial nerve palsy is NOT a contraindication to functional bracing outcomes 90% union rate increased risk with proximal third oblique or spiral fracture varus angulation is common but rarely has functional or cosmetic sequelae damage control orthopaedics (DCO) closed humerus fractures, including low velocity GSW, should be initially managed with a splint or sling type of fixation after trauma should be directed by acceptable fracture alignment parameters, fracture pattern and associated injuries Operative open reduction and internal fixation (ORIF) absolute indications open fracture vascular injury requiring repair brachial plexus injury ipsilateral forearm fracture (floating elbow) compartment syndrome periprosthetic humeral shaft fractures at the tip of the stem relative indications bilateral humerus fracture polytrauma or associated lower extremity fracture allows early weight bearing through humerus pathologic fractures burns or soft tissue injury that precludes bracing fracture characteristics distraction at fracture site short oblique or transverse fracture pattern intraarticular extension intramedullary nailing (IMN) relative indications pathologic fractures segmental fractures severe osteoporotic bone overlying skin compromise limits open approach polytrauma Techniques Coaptation Splint & Functional Bracing coaptation splint applied until swelling resolves adequately applied splint will extend up to axilla and over shoulder common deformities include varus and extension valgus mold to counter varus displacement functional bracing extends from 2.5 cm distal to axilla to 2.5 cm proximal to humeral condyles sling should not be used to allow for gravity-assisted fracture reduction shoulder extension used for more proximal fractures weekly radiographs for first 3 weeks to ensure maintenance of reduction every 3-4 weeks after that Open Reduction and Internal Fixation (ORIF) approaches anterior (brachialis split) approach to humerus used for middle third shaft fractures deep dissection through internervous plane of brachialis muscle lateral fibers (radial n.) and medial fibers (musculocutaneous n.) in majority of patients (~80%) anterolateral approach to humerus used for proximal third to middle third shaft fractures distal extension of the deltopectoral approach radial nerve identified between the brachialis and brachioradialis distally posterior approach to humerus used for distal to middle third shaft fractures although can be extensile triceps may either be split or elevated with a lateral paratricipital exposure radial nerve is found medial to the long and lateral heads and 2cm proximal to the deep head of the triceps radial nerve exits the posterior compartment through lateral intramuscular septum 10 cm proximal to radiocapitellar joint lateral brachial cutaneous/posterior antebrachial cutaneous nerve serves as an anatomic landmark leading to the radial nerve during a paratricipital approach techniques plate osteosynthesis commonly with 4.5mm plate (narrow or broad) 3.5mm plates may function adequately absolute stability with lag screw or compression plating in simple patterns apply plate in bridging mode in the presence of significant comminution postoperative full crutch weight bearing shown to have no effect on union Intramedullary Nailing (IMN) techniques can be done antegrade or retrograde complication nonunion nonunion rates not shown to be different between IMN and plating in recent meta-analyses IM nailing associated with higher total complication rates shoulder pain increased rate when compared to plating (16-37%) functional shoulder outcome scores (ASES scores) not shown to be different between IMN and ORIF nerve injury while controversial, a recent meta-analysis showed no difference between the incidence of radial nerve palsy between IMN and plating radial nerve is at risk with a lateral to medial distal locking screw musculocutaneous nerve is at risk with an anterior-posterior locking screw postoperative full weight bearing allowed and had no effect on union Complications Humeral shaft fx nonunion no callous on radiograph and gross motion at the fracture site at 6 weeks from injury has a 90-100% PPV of going on to nonounion in closed humeral shaft fractures Malunion varus angulation is common but rarely has functional or cosmetic sequelae risk factors transverse fracture patterns Radial nerve palsy incidence seen in 8-15% of closed fractures increased incidence distal one-third fractures (22%) neuropraxia most common injury in closed fractures and neurotomesis in open fractures iatrogenic radial nerve palsy is most common following ORIF via a lateral approach (20%) or posterior approach (11%) 85-90% of improve with observation over 3 months spontaneous recovery found at an average of 7 weeks, with full recovery at an average of 6 months treatment observation indicated as initial treatment in closed humerus fractures obtain NCS/EMG at ~2 months useful to determine extent of nerve damage, baseline of function, and to monitor recovery wrist extension in radial deviation is expected to be regained first brachioradialis first to recover, extensor indicis is the last surgical exploration indications open fracture with radial nerve palsy (likely neurotomesis injury to the radial nerve) closed fracture that fails to improve over ~4-6 months fibrillations (denervation) seen on EMG tendon transfers indications persistent radial nerve palsy - optimal timing debated wrist extension: PT to ECRB finger extension: FCR/FCU to EDC thumb extension: PL to EPL
Technique Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Humerus Shaft Fracture ORIF with Anterolateral Approach Orthobullets Team Trauma - Humeral Shaft Fractures Technique Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Humerus Shaft ORIF with Posterior Approach Orthobullets Team Trauma - Humeral Shaft Fractures
QUESTIONS 1 of 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ19.213) Figure A is the AP radiograph of a 32-year-old right-hand dominant male who was involved in a motor vehicle accident and sustained an isolated injury. On examination, he has good distal pulses, weakness with attempted wrist extension, and some reported numbness of the dorsal radial hand. He is treated conservatively in a Sarmiento functional brace. Which muscle function is expected to be the LAST to return in this patient? QID: 214115 FIGURES: A B C D E F Type & Select Correct Answer 1 Figure B 5% (91/1670) 2 Figure C 4% (62/1670) 3 Figure D 4% (65/1670) 4 Figure E 3% (44/1670) 5 Figure F 83% (1393/1670) L 2 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (OBQ19.251) A 60-year-old male with a history of diabetes presents to the trauma bay after sustaining a ground-level fall onto his right arm. His injury films are shown in Figures A and B. He is treated conservatively with closed reduction and his post-reduction radiographs are shown in Figures C and D. At 6 weeks followup he presents with persistent fracture site motion. His current imaging studies are shown in Figures E and F. Which of the following is the best next step in management? QID: 214153 FIGURES: A B C D E F Type & Select Correct Answer 1 Adjust Sarmiento brace and repeat followup in 3 weeks 6% (86/1527) 2 Continue current management for another 6 weeks and then discontinue brace 1% (14/1527) 3 Proceed with surgical management at this time 87% (1336/1527) 4 Continue current management for another 6 weeks and if no evidence of clinical union, proceed with surgical management 5% (80/1527) 5 Discontinue sarmiento brace and allow for progressive weight-bearing at this time 0% (1/1527) L 1 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ18TR.6) A 45-year-old man presents to your clinic with a closed mid-shaft humerus fracture after a fall 1 week prior. He is neurovascularly intact. After a discussion of his treatment options, he is adamant about proceeding with surgical management. With respect to open reduction and internal fixation with a plate versus intramedullary nailing, what advice can you offer him? QID: 211166 FIGURES: A Type & Select Correct Answer 1 Nailing is associated with a decreased rate of surgical site infections 8% (140/1793) 2 Nailing is associated with a higher rate of transient radial nerve injury 9% (163/1793) 3 Plating is associated with a higher rate of fracture union 21% (385/1793) 4 Plating is associated with a higher re-operation rate 4% (64/1793) 5 No difference between rate of radial nerve palsy between plating or nailing this injury 57% (1025/1793) L 4 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (OBQ18.209) A 65-year-old man sustained the closed injury seen in Figures A and B and is being treated nonoperatively in a functional brace. At what time point after the injury does the lack of callus formation and motion at the fracture site first become concerning for nonunion? QID: 213105 FIGURES: A B Type & Select Correct Answer 1 2 weeks 1% (14/2216) 2 4 weeks 4% (82/2216) 3 6 weeks 54% (1196/2216) 4 12 weeks 25% (565/2216) 5 6 months 16% (345/2216) L 4 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ13.14) A 30-year-old man is brought to your level 1 trauma center with a closed left diaphyseal humerus fracture, a closed left midshaft femur fracture, right sided rib fractures, and multiple facial fractures following a motorcycle accident. He is neurovascularly intact in his left arm and leg. Figure A shows a radiograph of his left humerus. What would be the most appropriate definitive treatment? QID: 4649 FIGURES: A Type & Select Correct Answer 1 Non-operative management of the humerus and plating of the femur 0% (13/4005) 2 Plating of the humerus and intramedullary nailing of the femur 85% (3385/4005) 3 Non-operative management of the humerus and intramedullary nailing of the femur 11% (439/4005) 4 Plating of both the humerus and femur 1% (45/4005) 5 Intramedullary nailing of the humerus and plating of the femur 2% (92/4005) L 1 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (SBQ12TR.18) A 21-year-old male is brought to the emergency department with multiple gun shot wounds. Initial radiographic evaluation discovers a femoral shaft fracture, distal tibia fracture, and the injury shown in Figure A. Figure B shows a single entry wound located at the left distal humerus. Systemic injuries include multiple abdominal bullet wounds with associated intra-abdominal free fluid. Using the 'damage-control' approach to orthopaedic trauma, what would be the best initial management for the injury seen in Figure A? QID: 3933 FIGURES: A B Type & Select Correct Answer 1 Closed reduction and splinting in the emergency room 42% (1199/2838) 2 Irrigation and debridement, then splinting in the operating room 17% (473/2838) 3 Irrigation and debridement, then spanning external fixation in the emergency room 38% (1089/2838) 4 Open reduction and internal fixation with a compression plate in the operating room 1% (25/2838) 5 Irrigation and debridement, then intramedullary nailing of the humerus in the operating room 1% (26/2838) L 4 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic (SBQ12TR.6) A 45-year-old female presents to the office wearing a right upper arm splint with radiographs shown in Figure A and B. She sustained an isolated closed injury to the right arm 9 days ago. Her soft-tissues and neurological examination are normal. What would be the most appropriate treatment for this injury? QID: 3921 FIGURES: A B Type & Select Correct Answer 1 Continue current splint for 6 weeks 3% (71/2617) 2 Continue current splint for 3 weeks and transition to hanging arm sling for additional 3 weeks 6% (156/2617) 3 Transition to functional brace for additional 6-8 weeks 87% (2282/2617) 4 Open reduction internal fixation with compression plating 3% (89/2617) 5 Staged procedure with humeral external fixator, then open reduction internal fixation with compression plating 0% (3/2617) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ12.214) A 25 year-old-male presents with the injury seen in Figure A. Which of the following would be a contraindication to closed management with a functional brace? QID: 4574 FIGURES: A Type & Select Correct Answer 1 Radial nerve injury 10% (249/2600) 2 1 cm shortening 2% (44/2600) 3 20 degree varus deformity 6% (153/2600) 4 Brachial plexus injury 77% (1998/2600) 5 Comminuted fracture pattern 6% (145/2600) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ12TR.13) A 23-year-old man presents with the injury seen in Figure A after a motor vehicle collision. He undergoes the treatment seen in Figure B. Which of the following statements is most accurate when comparing his treatment with open reduction and internal fixation? QID: 3928 FIGURES: A B Type & Select Correct Answer 1 Higher rates of radial nerve injury 12% (535/4481) 2 Higher total complication rate 72% (3213/4481) 3 Lower rates of nonunion 7% (311/4481) 4 Lower rates of shoulder impingement 3% (133/4481) 5 Lower rates of malunion 6% (270/4481) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (OBQ12.166) A 42-year-old man sustains the injury shown in Figure A after a fall from 6 feet. Physical exam after the injury reveals a flaccid ipsilateral limb. An MRI is performed that reveals nerve root avulsions from C5-T1. Which of the following is the most appropriate management of his fracture at this time? QID: 4526 FIGURES: A Type & Select Correct Answer 1 Closed management with a coaptation splint 6% (279/5008) 2 Closed management with a coaptation splint followed by transition to a functional brace after 7-10 days 18% (884/5008) 3 External fixation of humeral shaft fracture until brachial plexus injury resolves 2% (114/5008) 4 Open reduction, surgical fixation with plating 71% (3570/5008) 5 Closed management with a sling until brachial plexus injury resolves 2% (115/5008) L 3 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (OBQ12.66) A 26-year-old right hand dominant male is involved in a motor vehicle collision and sustains the left humerus injury demonstrated in Figure A. The brachial artery is disrupted and requires urgent attention in the operating room. The patient's preoperative nerve evaluation demonstrates that the patient is unable to initiate extensor carpi radialis longus, extensor carpi radialis brevis, extensor pollicis brevis, extensor digitorum, extensor indicis proprius, and extensor pollicis longus motor activity. What is the most likely etiology for this observed neurologic examination? QID: 4426 FIGURES: A Type & Select Correct Answer 1 Neurapraxia of the median nerve 1% (59/5966) 2 Axonotmesis of the radial nerve 27% (1600/5966) 3 Neurotmesis of the ulnar nerve 1% (54/5966) 4 Neurotmesis of the radial nerve 70% (4185/5966) 5 Axonotmesis of the ulnar nerve 0% (7/5966) L 3 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ10.125) A 45-year-old male sustains a Gustilo and Anderson Type II open transverse humeral shaft fracture. He undergoes the treatment shown in Figures A and B. What is the advantage of this treatment choice as compared to antegrade intramedullary nailing? QID: 3219 FIGURES: A B Type & Select Correct Answer 1 Decreased risk of post-operative elbow pain 8% (123/1598) 2 Decreased risk of radial nerve injury 19% (302/1598) 3 Decreased risk of reoperation 70% (1115/1598) 4 Decreased risk of infection 2% (35/1598) 5 Decreased risk of blood loss 1% (14/1598) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ09.210) A 32-year-old man presents to the emergency department with a humeral shaft fracture. He has wrist drop as well as impaired finger and thumb extension. Which motor function would be expected to recover last? QID: 3023 Type & Select Correct Answer 1 Elbow extension 1% (22/1632) 2 Forearm supination 1% (24/1632) 3 Wrist extension in radial deviation 7% (122/1632) 4 Middle finger MCP extension 11% (173/1632) 5 Index finger MCP hyperextension 79% (1286/1632) L 1 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ09.188) During an open reduction internal fixation of a humerus fracture using the posterior approach, a surgeon can identify the posterior antebrachial cutaneous nerve and trace it proximally to which of the following nerves? QID: 3001 Type & Select Correct Answer 1 Ulnar 2% (23/1192) 2 Musculocutaneous 10% (115/1192) 3 Radial 81% (969/1192) 4 Median 1% (11/1192) 5 Axillary 5% (58/1192) L 1 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ09.183) On average, the radial nerve travels from the posterior compartment of the arm and enters the anterior compartment at which of the following sites? QID: 2996 Type & Select Correct Answer 1 Spiral groove of the humerus 14% (169/1211) 2 At the arcuate ligament of Osborne 6% (73/1211) 3 10 cm distal to the lateral acromion 4% (53/1211) 4 10 cm proximal to radiocapitellar joint 72% (875/1211) 5 At the origin of the deep head of the triceps 3% (33/1211) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ08.177) All of the following are considered contraindications to the use of functional bracing of a humeral shaft fracture EXCEPT: QID: 563 Type & Select Correct Answer 1 Mid-diaphyseal segmental fracture with ipsilateral pilon fracture 7% (89/1212) 2 Mid-diaphyseal fracture with radial nerve palsy from nonballistic penetrating injury 9% (106/1212) 3 Proximal one-third oblique fracture 11% (138/1212) 4 Mid-diaphyseal closed fracture with a radial nerve palsy on presentation 65% (791/1212) 5 Mid-diaphyseal fracture with a L1 burst fracture and paraplegia on presentation 7% (81/1212) L 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (OBQ08.122) Which of the following is true regarding plating of humeral shaft fractures compared to intramedullary nailing? QID: 508 Type & Select Correct Answer 1 worse functional results 1% (9/1029) 2 higher need for subsequent surgeries 4% (44/1029) 3 higher incidence of radial nerve injury 26% (266/1029) 4 lower complication rates 48% (498/1029) 5 decreased nonunion rates 20% (204/1029) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (OBQ07.265) Which of the following is the strongest indication for surgical treatment of an acute humeral shaft fracture? QID: 926 Type & Select Correct Answer 1 radial nerve palsy 5% (114/2434) 2 long oblique fracture type 1% (14/2434) 3 comminuted fracture 1% (30/2434) 4 Holstein-Lewis fracture type 4% (88/2434) 5 ipsilateral both bone forearm fracture 90% (2179/2434) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (OBQ05.110) A 25-year-old male sustains a humeral shaft fracture and is treated with the implant seen in Figure A. Compared with open reduction and internal fixation with a plate and screw construct, the treatment shown in Figure A is associated with all of the following EXCEPT? QID: 996 FIGURES: A Type & Select Correct Answer 1 Increased shoulder impingement 6% (141/2217) 2 No difference in rate of union 7% (152/2217) 3 Increased shoulder range of motion 66% (1474/2217) 4 No difference in rate of radial nerve injury 13% (284/2217) 5 Increased risk of revision surgery 7% (152/2217) L 3 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ05.74) A polytrauma patient sustains a right bicondylar tibial plateau fracture and a right humeral shaft fracture both treated with open reduction and internal fixation. He also underwent statically locked intramedullary nailing of a left femoral shaft fracture. What is the appropriate weightbearing status? QID: 960 Type & Select Correct Answer 1 Non-weight bearing bilateral lower extremities and right upper extremity 4% (43/996) 2 Weight bearing as tolerated bilateral lower extremities and right upper extremity 2% (19/996) 3 Non-weight bearing left lower extremity and weight bearing as tolerated right upper and right lower extremities 2% (20/996) 4 Non-weight bearing right lower extremity and weight bearing as tolerated right upper and left lower extremities 88% (875/996) 5 Weight bearing as tolerated bilateral lower extremities and non-weight bearing right upper extremity 3% (30/996) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic (OBQ05.106) A 25-year-old male involved in a motor vehicle accident sustains multiple injuries. He undergoes operative treatment for his humeral shaft fracture. Figures A and B show his preoperative and postoperative radiographs. The distal interlocks for this implant place which of the following nerves at risk? QID: 992 FIGURES: A B Type & Select Correct Answer 1 Radial 33% (544/1667) 2 Ulnar 4% (72/1667) 3 Anterior interosseous 16% (266/1667) 4 Axillary 0% (7/1667) 5 Musculocutaneous 46% (762/1667) L 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (OBQ04.111) A 68-year-old male sustains the humeral shaft fracture shown in Figures A and B. Upon presentation, he is unable to extend his thumb, fingers, and wrist. After 4 months of non-operative management, the fracture has healed, but his physical exam is unchanged. What is the next most appropriate step in management? QID: 1216 FIGURES: A B Type & Select Correct Answer 1 EMG and nerve conduction tests 86% (2125/2473) 2 Continued observation 12% (297/2473) 3 Immediate surgical exploration 2% (39/2473) 4 Shoulder MRI 0% (3/2473) 5 CT scan of the humerus 0% (4/2473) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic
L 3 Rockwood And Green’s: Fractures in Adults Rockwood and Green's Fractures in Adults. Chapter 36: HUMERAL SHAFT FRACTURES Christos Garnavos Trauma - Humeral Shaft Fractures Christos Garnavos, 44 views 0.5
All Videos (17) Podcasts (1) Login to View Community Videos Login to View Community Videos Middle Atlantic Shoulder & Elbow Society Annual Meeting Panel: Trauma to the Humerus Top to Bottom (North to South)....Come on Down! - Raymond A. Pensy, MD Raymond A. Pensy Trauma - Humeral Shaft Fractures 12/20/2022 21 views 0.0 (0) Login to View Community Videos Login to View Community Videos Orthopaedic Summit Evolving Techniques 2020 Evolving Technique: Distal Articular Fractures Of The Humerus: 7 Tips & Tricks For A Great Outcome - Michael McKee, MD Michael D. McKee Trauma - Humeral Shaft Fractures 3/25/2022 174 views 0.0 (0) Login to View Community Videos Login to View Community Videos Cleveland Combined Hand Fellowship Lecture Series 2021-2022 Humerus Fractures with Radial Nerve Palsy - Michael Webber, MD Michael Webber Trauma - Humeral Shaft Fractures B 3/2/2022 205 views 5.0 (1) Trauma | Humeral Shaft Fractures Trauma - Humeral Shaft Fractures Listen Now 23:45 min 10/16/2019 1564 plays 4.9 (7) See More See Less
Middle Atlantic Shoulder & Elbow Society Annual Meeting Distal Humeral Shaft Fracture in 22F (C102067) Joseph Abboud Mohamad Fares Trauma - Humeral Shaft Fractures A 7/5/2022 10194 58 75 Open humeral shaft fracture 60M (C101664) Jacob Triplet Trauma - Humeral Shaft Fractures B 12/8/2020 495 10 1 Left diaphyseal humeral shaft fracture in a 25M (C101660) David B. Johnson Jr. Trauma - Humeral Shaft Fractures B 12/7/2020 263 9 0 See More See Less