Humeral Shaft Fracture

Question 1

What is the MOI

Answer 1

1. Direct blow to arm OR
2. FOOSH

Question 2

What are the symptoms?

Answer 2

1. Pain
2. Swelling
3. Deformity
4. Motion at fracture site
5. Inability to extend wrist/fingers (Wrist drop)
6. Loss of sensation of dorsal hand
   *must r/o radial nerve injury

Question 3

What will be found on the PE?

Answer 3

1. Swelling
2. Contusion
3. Puncture wounds (maybe)
4. Neurovascular exam
5. Shoulder and elbow assessment

Question 4

What diagnostic test should be completed?

Answer 4

1. XRays of humerus
   *AP, int, oblique
   *need to include the shoulder and the elbow

Question 5

What are some adverse outcomes of a humeral shaft fracture?

Answer 5

1. Radial nerve injury
2. Malunion (angulation)

Question 6

What are the non surgical treatment options?

Answer 6

1. Done with most fracture
   *up to 20 degrees of Angulation
   *splinting and sling used for treatment
   *sugar tong splint/coaptation splint
   *sling & swathe

Question 7

When are surgical treatment options recommended?

Answer 7

1. Open fractures
2. Neurovascular injury
3. “Floating elbow” syndrome

Question 8

What are the adverse outcomes of the fracture and/or treatment?

Answer 8

1. Radial nerve injury
2. Refer all cases to ortho
3. With peds suspect child abuse