Humeral Shaft Fracture - Everything You Need To Know - Dr. Nabil Ebraheim

Video Description

Dr. Ebraheim’s educational animated video describes fracture fixation of the humerus.
There is a high incidence of radial nerve injury associated with humeral shaft fracture, especially involving the holstein –lewis fracture located in the third of the humeral shaft.
Treatment of the humeral shaft fractures is usually nonoperative with a coaptation splint for 10 weeks followed by a functional brace.
This treatment is proven to be successful in the majority of cases with a 90% union rate.
Acceptable alignment is less than 20° of the anterior posterior angulation.
Less than 30° of varus or valgus angulation and less than 3 cm of shortening is also acceptable.
This angulation may not look good on an x-ray, but it does not usually affect the function of the patient.
Surgical treatment of humeral fractures is usually done for:
• Open fractures.
• Vascular injuries.
• Brachial plexus palsy.
• Multiple trauma.
• Floating elbow.
• Pathologic fracture.
The most common fixation used in humeral shaft fractures.
Diaphasis (shaft), types of fractures:
Simple
Wedge
Complex: types of fixation: plate, rod.
External fixator: near fracture, away from fracture.
Dyaphysis (shaft):
- External fixation of the humerl diapyseal fractures is not commonly used.
- Plate fixation is better than a rod.
- Plate fixation- more stable, less reoperation.
- Rod fixation- less stable, more reoperation.
- Humeral rod may result in shoulder stiffness and pain around the shoulder.
- External fixation near the fracture is not advisable.
- There is more of a risk of injury to the radial nerve.
Diaphysis (shaft) NONUNION:
- Usually plate and bone graft or bone graft substitute.
- Treatment on following IM rod fixation: remove IM rod and fix the fracture with a plate and bone graft or bone graft substitute.
- Open fracture: debride the wound and select the appropriate fixation of the fracture.
- Open fracture with nerve palsy: debride the wound, explore the nerve, and fix the fracture.



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