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  • Humeral Shaft Fracture Discussion

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    Rushda
    93 vizualizări18 pagini
    The document discusses humeral shaft fractures, including their definition, classification as closed or open, epidemiology, anatomy, mechanisms of injury, diagnosis, and treatment methods. Humeral shaft fractures are common injuries representing 3-5% of fractures, with a bimodal age distribution. Treatment involves restoring function through fracture reduction, immobilization, and rehabilitation, and can be done non-operatively through casting or operatively with plating, nailing, or external fixation depending on the fracture characteristics and patient factors. Complications can include nonunion, implant failure, infection, and radial nerve injury.

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    Fraktur Humerus

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    Fraktur Humerus

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    The document discusses humeral shaft fractures, including their definition, classification as closed or open, epidemiology, anatomy, mechanisms of injury, diagnosis, and treatment methods. Humeral shaft fractures are common injuries representing 3-5% of fractures, with a bimodal age distribution. Treatment involves restoring function through fracture reduction, immobilization, and rehabilitation, and can be done non-operatively through casting or operatively with plating, nailing, or external fixation depending on the fracture characteristics and patient factors. Complications can include nonunion, implant failure, infection, and radial nerve injury.

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    © All Rights Reserved
    Descărcați ca PPTX, PDF, TXT sau citiți online pe Scribd
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    93 vizualizări18 pagini

    Humeral Shaft Fracture Discussion

    Încărcat de

    Rushda
    The document discusses humeral shaft fractures, including their definition, classification as closed or open, epidemiology, anatomy, mechanisms of injury, diagnosis, and treatment methods. Humeral shaft fractures are common injuries representing 3-5% of fractures, with a bimodal age distribution. Treatment involves restoring function through fracture reduction, immobilization, and rehabilitation, and can be done non-operatively through casting or operatively with plating, nailing, or external fixation depending on the fracture characteristics and patient factors. Complications can include nonunion, implant failure, infection, and radial nerve injury.

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    © All Rights Reserved
    Descărcați ca PPTX, PDF, TXT sau citiți online pe Scribd
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    din 18

    DISCUSSION

    DEFENITION

    Fracture a break in the structural


    continuity of bone, cartilage, joint and
    growth plate

    Nalyagam S. Principles of Fractures. In: Solomon L. Apleys System of Orthopaedics and Fractures Ninth edition. 2010

    CLASIFICATION OF FRACTURE
    If overlying skin remains intact closed

    fracture
    If skin not intact Open facture
    CLOSED FRACTURED
    OPEN FRACTURED

    Nalyagam S. Principles of Fractures. In: Solomon L. Apleys System of Orthopaedics and Fractures Ninth edition. 2010

    EPIDEMIOLOGY
    A common injury,
    representing3% to
    5% of all
    fractures.

    Incidence is 14.5
    per 100,000 per
    year.

    Sixty percent
    involve middle
    third of the
    diaphysis, 30%
    involve
    proximal third of
    diaphysis, and
    I0% involve distal
    third of diaphysis.

    Bimodal age
    distribution with a
    peak in the third
    decade is seen in
    males and peak in
    the seventh
    decade is seen in
    females.

    ANATOMY

    Thompson, John C. Thigh/Hip: Netter's Concise Orthopaedic Anatomy. 2th Edition..Philadelphia: Saunders Elsevier. 2010.p.
    250-3, 266-8.

    ANTERIOR COMPARTEMENT

    Thompson, John C. Thigh/Hip: Netter's Concise Orthopaedic Anatomy. 2th Edition..Philadelphia: Saunders Elsevier. 2010.p.
    250-3, 266-8.

    POSTERIOR
    COMPARTEMENT

    Thompson, John C. Thigh/Hip: Netter's Concise Orthopaedic Anatomy. 2th Edition..Philadelphia: Saunders Elsevier. 2010.p.
    250-3, 266-8.

    MECHANISM OF INJURY
    DIRECT INJURY
    Direct trauma to the arm from a blow or motor vehicle
    accident results in a transverse or comminuted fracture.
    INDIRECT INJURY
    A fall on an outstretched arm results in spiral or oblique
    fractures, especially in the elderly. Throwing injuries with
    extreme muscular contraction and arm wrestling have also
    been reported to cause humeral shaft fractures.
    FRACTURE PATTERN DEPENDS ON THE TYPE
    OF FORCE
    Compressive: proximal or distal humerus fractures
    Bending: transverse fractures of the humeral shaft
    Torsional: spiral fractures of the humeral shaft
    Torsional and bending: oblique fracture, often accompanied
    by a butterfly fragment

    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    AO/ASIF CLASSIFICATION

    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    HOW TO DIAGNOSES
    HISTORY
    TAKING

    CLOSED
    FRACTURE
    1/3 MIDDLE
    RIGHT
    deformity (+), hematom
    HUMERUS
    (+), swelling
    (+),

    Pain at the right


    upper limb
    History o trauma

    CLINICAL
    EXAMINATION

    Tenderness (+)
    Pain of movement
    NVD is normaly

    IMAGING
    STUDIES

    Transverse
    fracture 1/3
    middle os
    humerus

    Apley s System of Orthopaedics and Fractures 9th Edition. UK: Arnold. 2010.

    Restore function

    Rehabilitatio
    n
    Recognize

    Fracture site, types of


    fracture

    Reduction

    For adequate
    apposition and normal
    alignment of bone

    Retain

    Maintain the reduction

    MANAGEME
    NT

    Initial Treatment
    Apply arm sling
    Pain alleviation
    To minimize soft tissue injury

    TREATMENT
    OPERATIV
    E
    NON
    OPERATIV
    E
    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    NON OPERATIVE TREATMENT


    METHOD OF NON OPERATIVE TREATMENT

    HANGING CAST

    COAPTATION
    SPLINT

    THORACOBRACIA
    L
    IMMOBILIZATION

    SHOULDER SPICA
    CAST

    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    NON OPERATIVE TREATMENT

    Thoracobrachial Immobilization
    (Vlapeu Dressing)

    Shoulder Spica Splint

    OPERATIVE TREATMENT
    INDICATION :
    Multiple trauma

    Inadequate closed
    reduction or
    unacceptable malunion

    Pathologic fracture

    Associated vascular
    injury

    Floating elbow

    Segmental fracture

    Intra-articular fracture
    extension

    Bilateral humeral
    fractures

    Open fracture

    Neurologic loss following


    penetrating trauma

    Brachial plexus injury

    Radial nerve palsy after


    fracture manipulation
    (controversial)

    Unfavorable body
    habitus such as morbid
    obesity or pendulous
    breasts (relative
    indication)

    Chronic shoulder or
    elbow stiffness as it
    results in increased
    motion through the
    fracture and increases
    the risk on nonunion
    (relative indication)

    Nonunion

    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    OPERATIVE TREATMENT
    METHOD OF OPERATIVE TREATMENT

    PLATING

    NAILING

    EXTERNA
    L
    FIXATION
    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

    COMPLICATION

    Non
    union

    Implant
    failure

    Infectio
    n

    Radial
    nerve
    injury

    Koval, Kenneth J.; Zuckerman, Joseph D. Handbook of Fractures, 4th Edition. USA: Lippincott Williams & Wilkins. 2006.p. 46475.

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